Individual provider Active NPI

Emily Mae Wolfram

  • Occupational Therapist
  • Fridley, MN
National Provider Identifier
1417711326
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
107381 Issued in MN
Practice address
7241 University Ave NE
Fridley, MN 55432-3134
Phone
(763) 450-9400
Fax
(763) 572-2616
NPI assigned
Feb 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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 107381 MN Primary

Addresses

Primary practice location

7241 University Ave NE
Fridley, MN 55432-3134

Mailing address

2225 Mapleview Ave
Maplewood, MN 55109-1441
Phone (651) 764-0335

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240911001004 MN Practitioner - Occupational Therapist in Private Practice 1759821234 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Therapy Special Children'S Clinic Occupational Therapist CurrentSince Jun 17, 2024 Accepting new patients

Locations

7241 University Ave NE
Minneapolis, MN 55432
Phone (763) 450-9400

Organizations & group practices 1

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": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1417711326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 MAPLEVIEW AVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091441",
            "telephone_number": "651-764-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7241 UNIVERSITY AVE NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554323134",
            "telephone_number": "763-450-9400",
            "fax_number": "763-572-2616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFRAM",
        "first_name": "EMILY",
        "middle_name": "MAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "107381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.