Active NPI
Susan Kaye Bludorn, RTA
- Recreational Therapist Assistant
- Minneapolis, MN
National Provider Identifier
1467164202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreational Therapist Assistant
- Practice address
- One Veteran Drive
Minneapolis, MN 55417-1679 - Phone
- (612) 467-7200
- NPI assigned
- Dec 22, 2022
- 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 |
|---|---|---|---|---|
| Recreational Therapist Assistant | 226000000X | Primary |
Addresses
Primary practice location
One Veteran Drive
Minneapolis, MN 55417-1679
Mailing address
One Veteran Drive
Minneapolis, MN 55417-1679
Phone (612) 467-7200
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671667200000",
"number": "1467164202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "ONE VETERAN DRIVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554171679",
"telephone_number": "612-467-7200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ONE VETERAN DRIVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554171679",
"telephone_number": "612-467-7200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUDORN",
"first_name": "SUSAN",
"middle_name": "KAYE",
"credential": "RTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-22",
"last_updated": "2022-12-22",
"certification_date": "2022-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "226000000X",
"taxonomy_group": "",
"desc": "Recreational Therapist Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.