Active NPI
Karen Kuehn, COTA
- Occupational Therapy Assistant
- Saint Cloud, MN
National Provider Identifier
1689199523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 201563
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 201563 | MN | MD | Occupational Therapy Assistant |
| 211640 | TX | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Community/Behavioral Health Agency
- Saint Cloud, MN
- NPI 1225372832
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.