Individual provider Active NPI

Taylor Lennartson, OTD

  • Occupational Therapist
  • Eden Prairie, MN
National Provider Identifier
1538985346
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
107614 Issued in MN
Practice address
6545 Flying Cloud Dr Ste 201
Eden Prairie, MN 55344-3356
Phone
(612) 364-1901
NPI assigned
Nov 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 107614 MN Primary

Addresses

Primary practice location

6545 Flying Cloud Dr Ste 201
Eden Prairie, MN 55344-3356

Mailing address

6545 Flying Cloud Dr Ste 201
Eden Prairie, MN 55344-3356

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241204000738 MN Practitioner - Occupational Therapist in Private Practice 2668908401 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

2025 Michaud Way
Centerville, MN 55038-4735
Phone (651) 316-0951

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107614MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Jul 15, 2025 Accepting new patients
Odom Sports Medicine, P.a. CurrentSince Dec 9, 2024 Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Jul 15, 2025 Accepting new patients
Aegis Group Practice LLC Occupational Therapist Current Accepting new patients

Locations

2025 Michaud Way
Centerville, MN 55038
Phone (651) 316-0951

6545 Flying Cloud Dr
Ste 201
Eden Prairie, MN 55344
Phone (612) 364-1901

10653 Wayzata Blvd
Ste 200
Minnetonka, MN 55305
Phone (612) 364-1901

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1538985346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 FLYING CLOUD DR STE 201",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6545 FLYING CLOUD DR STE 201",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443356",
            "telephone_number": "612-364-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENNARTSON",
        "first_name": "TAYLOR",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-26",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "107614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.