Active NPI
Ann Dahl, OT
- Occupational Therapist
- Faribault, MN
National Provider Identifier
1730414103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 101448
- Practice address
- 1961 Cardinal LN Ste a
Faribault, MN 55021-4354 - Phone
- (507) 333-2986
- Fax
- (507) 333-2918
- NPI assigned
- Oct 2, 2009
- 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 | 101448 | MN | Primary |
Addresses
Primary practice location
1961 Cardinal LN Ste a
Faribault, MN 55021-4354
Mailing address
21116 Monterey Ave
Prior Lake, MN 55372-8114
Phone (952) 440-7925
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100209000716 | MN | Practitioner - Occupational Therapist in Private Practice | 7719020924 |
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 1985
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1961 Cardinal LN
Suite a
Faribault, MN 55021-4353
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254441600000",
"number": "1730414103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21116 MONTEREY AVE",
"city": "PRIOR LAKE",
"state": "MN",
"postal_code": "553728114",
"telephone_number": "952-440-7925",
"fax_number": "507-333-2918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1961 CARDINAL LN STE A",
"city": "FARIBAULT",
"state": "MN",
"postal_code": "550214354",
"telephone_number": "507-333-2986",
"fax_number": "507-333-2918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAHL",
"first_name": "ANN",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-02",
"last_updated": "2009-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "101448",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Faribault, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.