Jessica Kelly Villery, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

105740 Issued in MN

Practice address

120 E Main St
Mankato, MN 56001-3501

Phone

(507) 322-5464

NPI assigned

Aug 10, 2018

Last updated

Jun 24, 2021By the provider in NPPES

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

Other names 1

• Dr. Jessica Kelly Tryhus Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St. Croix Psychiatric, LLC

  dba PrairieCare Medical Group

  • Psychiatry Physician
  • Woodbury, MN
  • NPI 1881849586
  NPD
• Fraser

  • Rehabilitation Clinic/Center
  • Richfield, MN
  • NPI 1063568574
  NPD (past)
• Fraser Child and Family Center

  • Adolescent and Children Mental Health Clinic/Center
  • Minneapolis, MN
  • NPI 1609922194
  NPD (past)

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1659850550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 ZANE AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431814",
            "telephone_number": "763-762-8800",
            "fax_number": "763-315-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E MAIN ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560013501",
            "telephone_number": "507-322-5464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "721 Commerce Drive",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "55125",
            "country_code": "US",
            "telephone_number": "651-424-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLERY",
        "first_name": "JESSICA",
        "middle_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-10",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "105740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "TRYHUS",
            "middle_name": "KELLY",
            "prefix": "DR.",
            "credential": "OTD, OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lindsey Vetter
• Angela Lee Vidden, LICSW
• Sandra L Vidotto, LICSW
• Kayleen Rae Vieburg, LICSW
• Andrew Villasenor, DO
• Britni Vincent, RD, LD
• Vine Faith in Action
• Vision World Inc (Vision World)
• Visionworks, Inc. (Visionworks)
• Erin Lee Visker, MS, NCC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.