Katie Jo Thayer, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

106229 Issued in MN

Practice address

2501 Rice Lake Rd
Duluth, MN 55811-4819

Phone

(218) 625-6400

NPI assigned

Jan 18, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Occupational Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Caring Edge Op LLCGroup PAC ID 6406114131, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Caring Edge Op LLC

  • Clinic/Center
  • Eagle, ID
  • NPI 1700399359
  Care Compare group NPD

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

{
    "created_epoch": "1610928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1649860297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5965 S PIKE LAKE RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558119627",
            "telephone_number": "218-590-6039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 RICE LAKE RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558114819",
            "telephone_number": "218-625-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAYER",
        "first_name": "KATIE",
        "middle_name": "JO",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-18",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "106229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Tester, RPH
• Shane Michael Tetzlaff, D.D.S.
• Megan Elizabeth Tezak, MSW, LICSW
• Nongnut Thao
• Jenni Anne Tharaldson, CNP
• The College of St Scholastica
• The College of St. Scholastica
• The Dental Specialist of Minnesota, PLLC
• The Duluth Clinic LTD
• The Duluth Clinic LTD

• Occupational Therapist in Duluth, MN
• Providers in Duluth, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.