Mary Ann Crosetto Johnson, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

106785 Issued in MN

Practice address

2653 County Road 74
Saint Cloud, MN 56301-2205

Phone

(320) 229-4069

NPI assigned

Feb 15, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Miss Mary Ann Crosetto Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• First Choice Childrens Homecare LP

  • Home Health Agency
  • Stafford, TX
  • NPI 1487634739
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1346706249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12840 62ND ST NE",
            "city": "SPICER",
            "state": "MN",
            "postal_code": "562889334",
            "telephone_number": "320-444-8986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2653 COUNTY ROAD 74",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563012205",
            "telephone_number": "320-229-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARY ANN",
        "middle_name": "CROSETTO",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-15",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "119642",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KS",
            "license": "17-03488",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MN",
            "license": "106785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "CROSETTO",
            "middle_name": "ANN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristin R. Johnson, R.D.
• Latora Johnson
• Laura Eva Johnson, RN,CNP
• Marissa Ann Virnig Johnson
• Mark E Johnson, MD
• Megan Johnson, CCC-SLP
• Mindy Lee Johnson, RN
• Molly J Johnson
• Nicole E Johnson, MS, CGC
• Nicolette R Johnson, LPCC; LADC/LMAC

• Pediatric Occupational Therapist in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Pediatric Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.