Active NPI
Constance S Shaffer, OTR L
- Occupational Therapist
- Golden Valley, MN
National Provider Identifier
1619918653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 102152
- Practice address
- 3915 Golden Valley Road
Courage Center
Golden Valley, MN 55422-4298 - Phone
- (763) 520-0425
- Fax
- (763) 520-0861
- NPI assigned
- Jun 9, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 102152 | MN | Primary |
| Driving and Community Mobility Occupational Therapist | 225XR0403X | 102152 | MN |
Addresses
Primary practice location
3915 Golden Valley Road
Courage Center
Golden Valley, MN 55422-4298
Mailing address
3915 Golden Valley Road
Courage Center
Golden Valley, MN 55422-4298
Phone (763) 520-0425
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6411150 | Other | MEDICA | |
| 76D35SH | Other | BCBS MINNESOTA | |
| HP11422 | Other | HEALTHPARTNERS |
Other names 1
- Constance M Saathoff
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
| License | State | Type | Specialty |
|---|---|---|---|
| 102152 | MN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323388800000",
"number": "1619918653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3915 GOLDEN VALLEY ROAD",
"address_2": "COURAGE CENTER",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "554224298",
"telephone_number": "763-520-0425",
"fax_number": "763-520-0861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3915 GOLDEN VALLEY ROAD",
"address_2": "COURAGE CENTER",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "554224298",
"telephone_number": "763-520-0425",
"fax_number": "763-520-0861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFFER",
"first_name": "CONSTANCE",
"middle_name": "S",
"credential": "OTR L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-09",
"last_updated": "2011-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "102152",
"primary": true
},
{
"code": "225XR0403X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Driving and Community Mobility",
"state": "MN",
"license": "102152",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "6411150",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MINNESOTA",
"identifier": "76D35SH",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP11422",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CONSTANCE",
"last_name": "SAATHOFF",
"middle_name": "M",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Golden Valley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.