Individual provider Active NPI

Carlie Danielle Rinas, OTR/L

  • Pediatric Occupational Therapist
  • Fargo, ND
National Provider Identifier
1639551377
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
104599 Issued in ND
Practice address
905 4TH St N
Fargo, ND 58102-3748
Phone
(701) 200-3038
Fax
(701) 645-7228
NPI assigned
Jun 18, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 104599 ND Primary

Addresses

Primary practice location

905 4TH St N
Fargo, ND 58102-3748

Mailing address

905 4TH St N
Fargo, ND 58102-3748
Phone (701) 200-3038

Other identifiers 2

IdentifierTypeStateIssuer
1422OtherNDNORTH DAKOTA OCCUPATIONAL THERAPY LICENSE
104599OtherMNLICENSED OCCUPATIONAL THERAPIST

Other names 1

  • Carlie Danielle Brekke Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150717000788 ND Practitioner - Occupational Therapist in Private Practice 5890008049 Reassigns benefits to 1 organization
Practice locations: Fargo, ND

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104599NDMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Blossoming Abilities PLLC Pediatrics CurrentSince Nov 24, 2025 Accepting new patients
Interact Therapy LLC CurrentSince Jul 25, 2022 Accepting new patients

Locations

3175 Sienna Dr S
Ste 103
Fargo, ND 58104
Phone (701) 532-1906

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": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1639551377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 4TH ST N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581023748",
            "telephone_number": "701-200-3038",
            "fax_number": "701-645-7228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 4TH ST N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581023748",
            "telephone_number": "701-200-3038",
            "fax_number": "701-645-7228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RINAS",
        "first_name": "CARLIE",
        "middle_name": "DANIELLE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-18",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "ND",
            "license": "104599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH DAKOTA OCCUPATIONAL THERAPY LICENSE",
            "identifier": "1422",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED OCCUPATIONAL THERAPIST",
            "identifier": "104599",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLIE",
            "last_name": "BREKKE",
            "middle_name": "DANIELLE",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.