Individual provider Active NPI

Amy R Carlson, OTR/L

  • Occupational Therapist
  • Rochester, MN
National Provider Identifier
1669623187
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4654-26 Issued in WI
Practice address
200 1St St SW
Rochester, MN 55905-0001
Phone
(507) 284-2511
NPI assigned
Oct 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 4654-26 WI Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905-0001

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other practice location 1

202 S Park St
Madison, WI 53715-1507
Phone (608) 417-6000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address acarlson2215768@ehrdirect.mayoclinicmsg.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081209000189 WI Practitioner - Occupational Therapist in Private Practice 7315008349 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4654-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince May 8, 2024 Accepting new patients
Paxxon Healthcare Services LLC Occupational Therapist CurrentSince Apr 28, 2024 Accepting new patients
Grace Lutheran Foundation, Inc Occupational Therapist CurrentSince Dec 27, 2025 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients
Paxxon Healthcare Services LLC Occupational Therapist CurrentSince Apr 28, 2024 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince May 8, 2024 Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

2441 New Pine Dr
Altoona, WI 54720
Phone (715) 832-3003

110 Park Dr
Colfax, WI 54730
Phone (715) 962-3186

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

1400 Bellinger St
Eau Claire, WI 54703
Phone (715) 838-3311

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1111 E Capitol Dr
Shorewood, WI 53211
Phone (262) 293-3207

Interoperability endpoints

  • Direct secure messaging: acarlson2215768@ehrdirect.mayoclinicmsg.org

Organizations & group practices 6

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": "1222905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1669623187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "202 S Park St",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537151507",
            "country_code": "US",
            "telephone_number": "608-417-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "AMY",
        "middle_name": "R",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-02",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4654-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "acarlson2215768@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559050001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.