Ebn Pediatric Occupational Therapy Services

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

103249 Issued in MN

Legal business name

EBN PEDIATRIC OCCUPATIONAL THERAPY SERVICES

Practice address

1072 Fillmore Cir NE
Fridley, MN 55432-5731

Phone

(612) 327-9324

NPI assigned

Dec 16, 2013

Organization subpart

No

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

Authorized official

Name

Erin Beussman, OTR/L

Title

Owner, Occupational Therapist

Phone

(612) 327-9324

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1387152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387324800000",
    "number": "1598186702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1072 FILLMORE CIR NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554325731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1072 FILLMORE CIR NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554325731",
            "telephone_number": "612-327-9324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBN PEDIATRIC OCCUPATIONAL THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-16",
        "last_updated": "2013-12-18",
        "status": "A",
        "authorized_official_last_name": "BEUSSMAN",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "OWNER, OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "612-327-9324",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MN",
            "license": "103249",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Marie Dusek Bertogliat, DPT
• Lisa Maria Dust, OTR
• Jessica Dworak, PT, DPT
• Zane Dye, APRN, FNP-C
• Judy A. Easley, M.D.
• Farhan Egal
• Yasser El-Said El-Hammamy, MD
• Daniel Elenz, PSYD, LP
• Matthew Elfmann, MA LADC, LPCC
• Beau John Elkington, LICSW, LADC, MBA

• Pediatric Occupational Therapist in Fridley, MN
• Providers in Fridley, MN by specialty
• Pediatric Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.