Individual provider Active NPI

Karen Kuehn, COTA

  • Occupational Therapy Assistant
  • Saint Cloud, MN
National Provider Identifier
1689199523
Registry record updated Nov 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
201563 Issued in MN
Practice address
3315 Roosevelt Rd Ste 200a
Saint Cloud, MN 56301
Phone
(320) 229-4069
Fax
(320) 229-4071
NPI assigned
Aug 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 211640 TX
Occupational Therapy Assistant 224Z00000X 2214 AK
Occupational Therapy Assistant 224Z00000X 201563 MN Primary

Addresses

Primary practice location

3315 Roosevelt Rd Ste 200a
Saint Cloud, MN 56301

Mailing address

3315 Roosevelt Rd Ste 200a
Saint Cloud, MN 56301-9737
Phone (320) 229-4069

Other practice location 1

3201 Cherry Ridge St
San Antonio, TX 78230-4823
Phone (210) 692-0222

Other names 1

  • Karen Goeddertz Former name

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
201563MNMDOccupational Therapy Assistant
211640TXMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rising Up, LLC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1502496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541721600000",
    "number": "1689199523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 ROOSEVELT RD STE 200A",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563019737",
            "telephone_number": "320-229-4069",
            "fax_number": "320-229-4071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 ROOSEVELT RD STE 200A",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "56301",
            "telephone_number": "320-229-4069",
            "fax_number": "320-229-4071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3201 Cherry Ridge St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782304823",
            "country_code": "US",
            "telephone_number": "210-692-0222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUEHN",
        "first_name": "KAREN",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-12",
        "last_updated": "2018-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "211640",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AK",
            "license": "2214",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MN",
            "license": "201563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "GOEDDERTZ",
            "credential": "COTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2018; 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.