Mary Alice Buettner, OTRL

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

771 Issued in ND

Practice address

921 43Rd Ave N
Fargo, ND 58102-5320

Phone

(701) 793-3646

Fax

(701) 293-6892

NPI assigned

Jan 11, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Milestone Therapeutics Inc

  • Rehabilitation Clinic/Center
  • Fargo, ND
  • NPI 1861540064
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1669522520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 25TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581035009",
            "telephone_number": "701-866-5344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 43RD AVE N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581025320",
            "telephone_number": "701-793-3646",
            "fax_number": "701-293-6892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUETTNER",
        "first_name": "MARY",
        "middle_name": "ALICE",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "ND",
            "license": "771",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MN",
            "license": "101102",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51413",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Ann Bueling, RN
• Brad R Buell, MD
• Julia Maryanna Buendgen
• Jennifer Bueschel
• Ann M Buettner, MD
• Steve Buettner
• Irene Buhendwa, RN
• Miguel Buisan Catevilla, RPH
• Alexandra Bulga, MD
• Robert E Bulik, CRNA

• Pediatric Occupational Therapist in Fargo, ND
• Providers in Fargo, ND by specialty
• Pediatric Occupational Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.