Peter Thomas Simon, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

107127 Issued in MN

Practice address

380 Oak Grove Pkwy
Vadnais Heights, MN 55127-8508

Phone

(952) 767-4200

NPI assigned

May 8, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1619666336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2731 91ST CRES N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554433831",
            "telephone_number": "763-381-7437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 OAK GROVE PKWY",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551278508",
            "telephone_number": "952-767-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "PETER",
        "middle_name": "THOMAS",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "107127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isra Ahmed Sheikh
• Shoptikal LLC
• Barbara A Siefken
• Rachel M Silbert, PA-C
• Corey Simmons
• Emily Christine Smith, MA, BCBA
• Katelyn Jean Smith
• Mary O'Shaughnessy Smith, OTR/L
• Daniel Allen Sonday, MS, ATC, OTC
• Tracy Marie St. Dennis, DDS

• Occupational Therapist in Vadnais Heights, MN
• Providers in Vadnais Heights, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.