Individual provider Active NPI

Carlyn Natalie Gilmore, OT

  • Occupational Therapist
  • Edina, MN
National Provider Identifier
1578766770
Registry record updated Dec 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
101216 Issued in MN
Practice address
6550 York Ave S
Suite 520
Edina, MN 55435-2347
Phone
(952) 924-0199
Fax
(952) 924-0314
NPI assigned
Jun 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2013

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 101216 MN Primary

Addresses

Primary practice location

6550 York Ave S
Suite 520
Edina, MN 55435-2347

Mailing address

10900 73Rd Ave N
Suite 110
Maple Grove, MN 55369-5458
Phone (763) 315-1296

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
101216MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Saunders Therapy Centers Inc Occupational Therapist PastSince Mar 1, 2009 Accepting new patients
Therapy Partners Inc Occupational Therapist Past Accepting new patients

Organizations & group practices 2

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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386806400000",
    "number": "1578766770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 73RD AVE N",
            "address_2": "SUITE 110",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553695458",
            "telephone_number": "763-315-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 YORK AVE S",
            "address_2": "SUITE 520",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352347",
            "telephone_number": "952-924-0199",
            "fax_number": "952-924-0314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "CARLYN",
        "middle_name": "NATALIE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2013-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "101216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.