Olivia Pemberton, OTR/L

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

104340 Issued in MN

Practice address

1095 Highway 15 S
Hutchinson, MN 55350-5000

Phone

(320) 484-4410

NPI assigned

Jul 22, 2021

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1497328918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16360 HIGHWAY 7",
            "city": "NEW GERMANY",
            "state": "MN",
            "postal_code": "553679510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 HIGHWAY 15 S",
            "city": "HUTCHINSON",
            "state": "MN",
            "postal_code": "553505000",
            "telephone_number": "320-484-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEMBERTON",
        "first_name": "OLIVIA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "MN",
            "license": "104340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Rehabilitation Occupational Therapist in Hutchinson, MN
• Providers in Hutchinson, MN by specialty
• Physical Rehabilitation Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; 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.