Individual provider Active NPI

Anna Marie Karraker, COTA

  • Occupational Therapy Assistant
  • Duluth, MN
National Provider Identifier
1548692759
Registry record updated Jul 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
201854 Issued in MN
Practice address
2501 Rice Lake Rd
Duluth, MN 55811-4819
Phone
(218) 625-6400
NPI assigned
Jul 30, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 201854 MN Primary
Occupational Therapy Assistant 224Z00000X 5016-27 WI

Addresses

Primary practice location

2501 Rice Lake Rd
Duluth, MN 55811-4819

Mailing address

S67W14570 Gaulke CT
Muskego, WI 53150-3171
Phone (262) 366-1911

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

State licenses

LicenseStateTypeSpecialty
201854MNMDOccupational Therapy Assistant
5016-27WIMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375142400000",
    "number": "1548692759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S67W14570 GAULKE CT",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531503171",
            "telephone_number": "262-366-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 RICE LAKE RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558114819",
            "telephone_number": "218-625-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARRAKER",
        "first_name": "ANNA",
        "middle_name": "MARIE",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-30",
        "last_updated": "2013-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MN",
            "license": "201854",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "5016-27",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; 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.