Krista Jo Minnis, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

5201006485 Issued in MI

Practice address

1525 Ridgewood Dr
Midland, MI 48642-6425

Phone

(989) 835-6333

Fax

(989) 835-3235

NPI assigned

Oct 18, 2023

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

State licenses

Practice roles

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.

• Children'S Therapy Corner Inc

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Midland, MI
  • NPI 1669418562
  NPD (past)

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

{
    "created_epoch": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1548042229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6006 WILLOWBROOK DR",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486385489",
            "telephone_number": "805-844-8758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 RIDGEWOOD DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486426425",
            "telephone_number": "989-835-6333",
            "fax_number": "989-835-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNIS",
        "first_name": "KRISTA",
        "middle_name": "JO",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-18",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MI",
            "license": "5201006485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Scott Miller
• Alexandra D Millikin
• Haley Millis
• Audrey J Mills
• Amy Miner
• Nicole Lynn Minnis, MA, LLP
• Lynne A Mischley, MSSW
• Michael J Mischley, PH.D.
• Alyssa Misiak, PT, DPT
• Kindra Ann Mitchell

• Pediatric Occupational Therapist in Midland, MI
• Providers in Midland, MI by specialty
• Pediatric Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.