Individual provider Active NPI

Christine Debra Hall, OTR

  • Occupational Therapist
  • Woodbury, MN
National Provider Identifier
1568693166
Registry record updated Jun 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
255808 Issued in MN
Practice address
8320 City Centre Dr
Suite G.
Woodbury, MN 55125-3382
Phone
(651) 738-9888
Fax
(651) 738-9889
NPI assigned
Jul 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2010

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 255808 MN Primary

Addresses

Primary practice location

8320 City Centre Dr
Suite G.
Woodbury, MN 55125-3382

Mailing address

15861 Flute Way
Apple Valley, MN 55124-6011
Phone (952) 953-9568

Other identifiers 1

IdentifierTypeStateIssuer
255808OtherMNLICENSE NUMBER

Other names 1

  • Christine Debra Larsen Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100819000267 MN Practitioner - Occupational Therapist in Private Practice 3678607140 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
255808MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Ops, LLC Occupational Therapist CurrentSince Feb 13, 2015 Accepting new patients

Locations

1312 S Frontage Rd
Hastings, MN 55033
Phone (651) 455-0561

2925 Buckley Way
Inver Grove Heights, MN 55076
Phone (651) 455-0561

Organizations & group practices 1

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": "1248912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276646400000",
    "number": "1568693166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15861 FLUTE WAY",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246011",
            "telephone_number": "952-953-9568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8320 CITY CENTRE DR",
            "address_2": "SUITE G.",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253382",
            "telephone_number": "651-738-9888",
            "fax_number": "651-738-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "CHRISTINE",
        "middle_name": "DEBRA",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-30",
        "last_updated": "2010-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "255808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "255808",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "LARSEN",
            "middle_name": "DEBRA",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.