Joanna Nicole Anderson, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

106436 Issued in MN

Practice address

1861 Commerce Blvd
Mound, MN 55364-1293

Phone

(952) 240-3285

NPI assigned

Mar 18, 2024

Last updated

Mar 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Aegis Group Practice LLC

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  • Fort Smith, AR
  • NPI 1417340126

  MN, Occupational Therapist

  Medicare reassignment NPD
• Aegis Group Practice LLC

  • Physical Therapist
  • Carver, MN
  • NPI 1083306419

  Occupational Therapist

  NPD
• Aegis Group Practice LLC

  • Physical Therapist
  • Indian Harbour Beach, FL
  • NPI 1932072030

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1366201626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4786 CARRICK RD",
            "city": "MOUND",
            "state": "MN",
            "postal_code": "553641873",
            "telephone_number": "612-601-6197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1861 COMMERCE BLVD",
            "city": "MOUND",
            "state": "MN",
            "postal_code": "553641293",
            "telephone_number": "952-240-3285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JOANNA",
        "middle_name": "NICOLE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "106436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Advanced Dental Care Services
• Aegis Group Practice LLC
• Grant U Anderton, PHARMD
• Bianca Bakardieva Ramos Da Silva, MA, LPCC, LADC
• James Michael Baldus, PH.D., L.P.
• Jo M Berger, MD
• Mi Ja Kang Bergerson, LICSW

• Occupational Therapist in Mound, MN
• Providers in Mound, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.