Innovative Therapy LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

INNOVATIVE THERAPY LLC

Practice address

5480 Nathan LN N Ste 140
Plymouth, MN 55442-1995

Phone

(612) 597-2975

NPI assigned

Jul 10, 2006

Last updated

Dec 19, 2017By 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

Mary Jo Danielson, MAOTR/LNPI 1467620039

Title

Owner/Occupational Therapist

Phone

(612) 597-2975

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

Practitioners 3

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.

• Mary Danielson

  • Occupational Therapist
  • Buffalo, MN
  • NPI 1467620039
  NPD (past) Authorized official
• Alexia Buslee, OTR

  • Occupational Therapist
  • Inver Grove Heights, MN
  • NPI 1780932038
  NPD
• Jeffrey John Evans, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Bloomington, MN
  • NPI 1417107335
  NPD

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513641600000",
    "number": "1447284435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1696 7TH ST NW",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553135050",
            "telephone_number": "612-597-2975",
            "fax_number": "763-682-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 NATHAN LN N STE 140",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554421995",
            "telephone_number": "612-597-2975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2017-12-19",
        "status": "A",
        "authorized_official_last_name": "DANIELSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "OWNER/OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "612-597-2975",
        "authorized_official_credential": "MAOTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128152600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U-CARE",
            "identifier": "183942",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• In Their World LLC
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• Infinite Health Collaborative, PA
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• Ingress Healthcare Inc
• Interactive Therapy Services of Minnesota Inc (Functional Kids Clinic)
• Interfaith Outreach & Community Partners
• Intermediate District 287
• Molly B Irvin, PA-C
• Marie Irvine, PTA

• Occupational Therapist in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; 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.