Individual provider Active NPI

Mykal Morstad

  • Occupational Therapy Assistant
  • Devils Lake, ND
National Provider Identifier
1669914784
Registry record updated Nov 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
377 Issued in ND
Practice address
801 5TH Ave SE
Devils Lake, ND 58301-3649
Phone
(701) 662-7690
NPI assigned
Nov 7, 2016
Last updated
Nov 7, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 377 ND Primary

Addresses

Primary practice location

801 5TH Ave SE
Devils Lake, ND 58301-3649

Mailing address

801 5TH Ave SE
Devils Lake, ND 58301-3649
Phone (701) 662-7690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
377NDMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Region Special Education Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1478476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478476800000",
    "number": "1669914784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 5TH AVE SE",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583013649",
            "telephone_number": "701-662-7690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 5TH AVE SE",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583013649",
            "telephone_number": "701-662-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORSTAD",
        "first_name": "MYKAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-07",
        "last_updated": "2016-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "ND",
            "license": "377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Devils Lake, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; 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.