Jade Renae Roberts, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

202847 Issued in MN

Practice address

6200 Xerxes Ave S
Edina, MN 55423-1033

Phone

(952) 925-8500

NPI assigned

Sep 12, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1726099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1699501981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10400 BREN RD E APT 537",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553430099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 XERXES AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554231033",
            "telephone_number": "952-925-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JADE",
        "middle_name": "RENAE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-12",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MN",
            "license": "202847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald Allen Ristad, MD
• Milan Ristic, DO
• Thomas Arthur Rivers, M.D.
• Steven Paul Robak, CPNP
• Robert K. Peterson DDS PA
• Heidi Robertson, M.D.
• NA Robideau, L.AC.
• Jordan Robinson, PH.D.
• Ubah Mohamed Roble
• Rocket Surgery, LLC

• Occupational Therapy Assistant in Edina, MN
• Providers in Edina, MN by specialty
• Occupational Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; 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.