Sprout Therapy Services LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

SPROUT THERAPY SERVICES LLC

Practice address

50438 W Lake Seven Rd
Frazee, MN 56544-8919

Phone

(218) 234-2094

Fax

(888) 892-2924

NPI assigned

Jun 19, 2023

Last updated

Mar 4, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jessica Reishus Davidson, OTR/LNPI 1205444619

Title

Occupational Therapist/Owner

Phone

(218) 371-6647

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessica Reishus Davidson, OTD, OTR/L

  • Occupational Therapist
  • Frazee, MN
  • NPI 1205444619
  Medicare reassignment NPD Authorized official
• Kayla Joy Muckenhirn, OTR/L

  • Occupational Therapist
  • Madison, WI
  • NPI 1417483744

  MN

  Medicare reassignment NPD

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1376228320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 193",
            "city": "VERGAS",
            "state": "MN",
            "postal_code": "565870193",
            "telephone_number": "218-234-2094",
            "fax_number": "888-892-2924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50438 W LAKE SEVEN RD",
            "city": "FRAZEE",
            "state": "MN",
            "postal_code": "565448919",
            "telephone_number": "218-234-2094",
            "fax_number": "888-892-2924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPROUT THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-19",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "REISHUS",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "218-371-6647",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Legacy Senior Services (Frazee Care Center)
• Paige Martelle, M.S., CCC-SLP
• Dena Corrine Mekalson, M.S., CCC-SLP
• Seip Drug LLC (Seip Drug)
• Lori Ann Sorenson, MS
• St Mary's Regional Health Center (Essentia Health St. Mary's-Frazee Clinic)
• St. Mary's Regional Health Center (Essentia Health St. Mary's - Frazee Clinic)
• Wendy Ann Stiegel, R.N.
• Paul Sweere
• Lori Vigesaa, MS, NCC, CI/CT, LPCC

• Occupational Therapist in Frazee, MN
• Providers in Frazee, 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 4, 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.