Active NPI
Mary Thorkildson
- Occupational Therapist
- Cambridge, MN
National Provider Identifier
1396860417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 100827
- Practice address
- 1994 E Rum River Dr S
Cambridge, MN 55008-2663 - Phone
- (763) 689-5385
- NPI assigned
- Mar 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 100827 | MN | Primary |
Addresses
Primary practice location
1994 E Rum River Dr S
Cambridge, MN 55008-2663
Mailing address
PO Box 535
Stephen, MN 56757-0535
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HP76308 | Other | MN | HEALTH PARTNERS |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100827 | MN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396860417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 535",
"city": "STEPHEN",
"state": "MN",
"postal_code": "567570535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1994 E RUM RIVER DR S",
"city": "CAMBRIDGE",
"state": "MN",
"postal_code": "550082663",
"telephone_number": "763-689-5385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THORKILDSON",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "100827",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP76308",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.