Individual provider Active NPI

Jennifer Rana Tvrdy, OTDRL

  • Occupational Therapist
  • Plymouth, MN
National Provider Identifier
1407914625
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
103355 Issued in MN
Practice address
14130 23Rd Ave N
Plymouth, MN 55447-4904
Phone
(763) 383-7666
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 103355 MN
Occupational Therapist 225X00000X 103355 MN Primary

Addresses

Primary practice location

14130 23Rd Ave N
Plymouth, MN 55447-4904

Mailing address

14130 23Rd Ave N
Plymouth, MN 55447-4904
Phone (763) 383-7666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150421000490 MN Practitioner - Occupational Therapist in Private Practice 3779801881 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
103355MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy for Me Inc Past Accepting new patients
Therapy for Me 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1407914625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14130 23RD AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554474904",
            "telephone_number": "763-383-7666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14130 23RD AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554474904",
            "telephone_number": "763-383-7666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TVRDY",
        "first_name": "JENNIFER",
        "middle_name": "RANA",
        "credential": "OTDRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MN",
            "license": "103355",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "103355",
            "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 Jul 2, 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.