Individual provider Active NPI

Diana Lynn Kivirahk, OTR/L, CHT

  • Occupational Therapist
  • Plymouth, MN
National Provider Identifier
1366614711
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
106010 Issued in MN
Practice address
2855 Campus Dr Ste 300
Plymouth, MN 55441-2682
Phone
(763) 520-7870
Fax
(763) 520-7580
NPI assigned
Mar 26, 2008
Last updated
Aug 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 106010 MN Primary

Addresses

Primary practice location

2855 Campus Dr Ste 300
Plymouth, MN 55441-2682

Mailing address

2855 Campus Dr Ste 300
Plymouth, MN 55441-2682
Phone (763) 520-7870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
106010MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Clinic Medical Group, Inc Past Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1366614711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 CAMPUS DR STE 300",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554412682",
            "telephone_number": "763-520-7870",
            "fax_number": "763-520-7580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 CAMPUS DR STE 300",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554412682",
            "telephone_number": "763-520-7870",
            "fax_number": "763-520-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIVIRAHK",
        "first_name": "DIANA",
        "middle_name": "LYNN",
        "credential": "OTR/L, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-26",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "106010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; 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.