Stacy Nicole Koelln, O.T.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

4415 W 36 1/2 St
St Louis Park, MN 55416-4854

Phone

(952) 927-9717

NPI assigned

Mar 14, 2008

Last updated

Mar 17, 2011By the provider in NPPES

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

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300320000000",
    "number": "1700057080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 W 36 1/2 ST",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164854",
            "telephone_number": "952-927-9717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 W 36 1/2 ST",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164854",
            "telephone_number": "952-927-9717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOELLN",
        "first_name": "STACY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-14",
        "last_updated": "2011-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Rapacz Knutson, PHARMD
• R Bruce Kobs, DDS
• Jill Renee Koch, P.T.
• Maggie J Koch, O.A.
• Kinga M Kocsis, M.D.
• Kendall Anne Koenen
• Olivia Claire Koenig
• Phillip M Kofron, M.D.
• Dawn Marie Kohner, C.R.N.A.
• Joanna C Kokoszka, M.D.

• Occupational Therapist in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; 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.