Kristin Suzanne Soderholm, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

101509 Issued in MN

Practice address

1107 Hart Blvd
Monticello, MN 55362-8538

Phone

(763) 295-6878

Fax

(763) 271-6860

NPI assigned

Nov 15, 2011

Last updated

Nov 15, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optage IncGroup PAC ID 2264619345, 61 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Optage Inc

  dba Eaglecrest

  • Rehabilitation Clinic/Center
  • Roseville, MN
  • NPI 1801517230

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Optage Inc

  dba Presbyterian Homes and Services Rehabilitation

  • Rehabilitation Clinic/Center
  • Chanhassen, MN
  • NPI 1427747997

  Occupational Therapist

  NPD
• Optage Inc

  dba Presbyterian Homes and Services Rehabilitation

  • Rehabilitation Clinic/Center
  • Mahtomedi, MN
  • NPI 1699464149

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1321315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321315200000",
    "number": "1487931622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 HART BLVD",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628538",
            "telephone_number": "763-295-6878",
            "fax_number": "763-271-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 HART BLVD",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628538",
            "telephone_number": "763-295-6878",
            "fax_number": "763-271-6860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODERHOLM",
        "first_name": "KRISTIN",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-15",
        "last_updated": "2011-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "101509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cory Simning, MD
• Tracie Sinclair, OTR/L
• Jennifer Lynn Smith, LMFT
• Maria A Smith
• Snyders Drug (Snyder Drug Emporium)
• Maria Gail Sorensen, LICSW
• Jodi Sorenson, LICSW
• Rachael Sorenson, OTR/L
• St. Benedict's Senior Community of Monticello
• Kendra Jo Stalpes, LPCC, LSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.