Shea Brogren, OTR

Primary specialty

Mental Health Occupational TherapistTaxonomy code 225XM0800X

License

1351 Issued in ND

Practice address

102 W Beaton Dr Ste 105
West Fargo, ND 58078

Phone

(701) 261-4643

Fax

(701) 540-9044

NPI assigned

Jul 2, 2014

Last updated

Oct 16, 2018By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Great Kids Therapy, LTD.

  • Occupational Therapist
  • Fargo, ND
  • NPI 1497805196
  NPD (past)

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1578979241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3507 EVERGREEN RD N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581021218",
            "telephone_number": "701-261-4643",
            "fax_number": "701-540-9044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W BEATON DR STE 105",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "58078",
            "telephone_number": "701-261-4643",
            "fax_number": "701-540-9044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6301 19th Ave NW",
            "address_purpose": "LOCATION",
            "city": "Minot",
            "state": "ND",
            "postal_code": "587038899",
            "country_code": "US",
            "telephone_number": "701-857-4232",
            "fax_number": "701-852-1190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6301 19th Ave NW",
            "address_purpose": "LOCATION",
            "city": "Minot",
            "state": "ND",
            "postal_code": "587038899",
            "country_code": "US",
            "telephone_number": "701-857-4232",
            "fax_number": "701-852-1190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROGREN",
        "first_name": "SHEA",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-02",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": "ND",
            "license": "1351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56430",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teri J Brekke, MPT
• Susan Lynn Brenan, R.PH.
• Bridging the Gap
• Erika Rae Briggs, OTR/L
• Brighter Care LLC
• Nicole Brower
• Abigail Brown
• Rachelle Brown, MS, LAPC
• Bruce L. Redington, D.C. (West Fargo Chiropractic Center)
• Casey L Brudvik

• Mental Health Occupational Therapist in West Fargo, ND
• Providers in West Fargo, ND by specialty
• Mental Health Occupational Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; 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.