Individual provider Active NPI

Kristin Ann Muzzy, MA, OTR/L

  • Occupational Therapist
  • Thief River Falls, MN
National Provider Identifier
1447557434
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
103846 Issued in MN
Practice address
310 Red Lake Blvd
Thief River Falls, MN 56701-2133
Phone
(218) 416-1482
Fax
(218) 416-1483
NPI assigned
Feb 28, 2011
Last updated
Jun 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1908 ND
Occupational Therapist 225X00000X 103846 MN Primary

Addresses

Primary practice location

310 Red Lake Blvd
Thief River Falls, MN 56701-2133

Mailing address

3060 Frontier Way S
Fargo, ND 58104-8909
Phone (701) 232-2340

Other practice location 1

2600 DeMers Ave Ste 101
Grand Forks, ND 58201-4100
Phone (701) 757-3045

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210917001014 MN Practitioner - Occupational Therapist in Private Practice 5294132296 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1908NDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Therapy Partners, Inc. CurrentSince Sep 12, 2021 Accepting new patients
Pediatric Therapy Partners, Inc. Occupational Therapist CurrentSince Jul 23, 2021 Accepting new patients
Adara Home Health, Inc. Past Accepting new patients
Quotable Kids Pediatric Therapy Clinic, PLLC Occupational Therapist PastSince Apr 1, 2020 Accepting new patients

Locations

310 Red Lake Blvd
Thief River Falls, MN 56701
Phone (218) 416-1482

419 Atlantic Ave
Thief River Falls, MN 56701
Phone (218) 416-1482

3060 Frontier Way S
Fargo, ND 58104
Phone (701) 356-4384

1811 S Washington St
Grand Forks, ND 58201
Phone (701) 757-3045

2600 Demers Ave
Ste 101
Grand Forks, ND 58201
Phone (701) 757-3045

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1298851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1447557434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 FRONTIER WAY S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048909",
            "telephone_number": "701-232-2340",
            "fax_number": "701-232-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 RED LAKE BLVD",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567012133",
            "telephone_number": "218-416-1482",
            "fax_number": "218-416-1483"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 DeMers Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582014100",
            "country_code": "US",
            "telephone_number": "701-757-3045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUZZY",
        "first_name": "KRISTIN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MA, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-28",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "1908",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "103846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thief River Falls, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.