Active NPI
Diana Lynn Skogen, OTRL
- Occupational Therapist
- Delavan, MN
National Provider Identifier
1720105331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 100274
- Practice address
- 44070 220TH St
Delavan, MN 56023-6814 - Phone
- (507) 525-3195
- NPI assigned
- Mar 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 100274 | MN | Primary |
Addresses
Primary practice location
44070 220TH St
Delavan, MN 56023-6814
Mailing address
44070 220TH St
Delavan, MN 56023-5473
Phone (507) 525-3195
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 130009100 | Medicaid | MN | |
| 185D9SK | Other | MN | BLUE CROSS BLUE SHIELD |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100274 | MN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409875200000",
"number": "1720105331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44070 220TH ST",
"city": "DELAVAN",
"state": "MN",
"postal_code": "560235473",
"telephone_number": "507-525-3195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44070 220TH ST",
"city": "DELAVAN",
"state": "MN",
"postal_code": "560236814",
"telephone_number": "507-525-3195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKOGEN",
"first_name": "DIANA",
"middle_name": "LYNN",
"credential": "OTRL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-26",
"last_updated": "2014-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "100274",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "130009100",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "185D9SK",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Delavan, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.