Individual provider Active NPI

Justine Ahmann, COTA/L

  • Occupational Therapy Assistant
  • Brooklyn Park, MN
National Provider Identifier
1700622206
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
202204 Issued in MN
Practice address
5200 Oak Grove Pkwy N
Brooklyn Park, MN 55443-4031
Phone
(763) 439-3499
NPI assigned
Jul 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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 202204 MN Primary

Addresses

Primary practice location

5200 Oak Grove Pkwy N
Brooklyn Park, MN 55443-4031

Mailing address

877 120TH LN NW
Coon Rapids, MN 55448-2273
Phone (763) 439-3499

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
202204MNMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1700622206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 120TH LN NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554482273",
            "telephone_number": "763-439-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 OAK GROVE PKWY N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554434031",
            "telephone_number": "763-439-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMANN",
        "first_name": "JUSTINE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MN",
            "license": "202204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.