Suzanne Christine Vetter, MOTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

105186 Issued in MN

Practice address

15620 Edgewood Dr Ste 240
Baxter, MN 56401-6984

Phone

(218) 454-7012

Fax

(218) 454-7015

NPI assigned

Jul 28, 2016

Last updated

Jan 5, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1548713316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CROSS ST",
            "city": "BIG STONE CITY",
            "state": "SD",
            "postal_code": "572168237",
            "telephone_number": "055-411-1406",
            "fax_number": "605-541-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15620 EDGEWOOD DR STE 240",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564016984",
            "telephone_number": "218-454-7012",
            "fax_number": "218-454-7015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 46th St S Apt 304",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581049009",
            "country_code": "US",
            "telephone_number": "218-850-2262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VETTER",
        "first_name": "SUZANNE",
        "middle_name": "CHRISTINE",
        "credential": "MOTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-28",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "360268",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "105186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.