Individual provider Active NPI

Kristel Dawn Croffoot, M.S., OTR/L

  • Occupational Therapist
  • Minot, ND
National Provider Identifier
1730462144
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2264 Issued in ND
Practice address
2080 36TH Ave SW Ste 110
Minot, ND 58701-7597
Phone
(701) 222-3175
Fax
(701) 222-3186
NPI assigned
Sep 21, 2011
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2264 ND Primary
Pediatric Occupational Therapist 225XP0200X 4911 AZ

Addresses

Primary practice location

2080 36TH Ave SW Ste 110
Minot, ND 58701-7597

Mailing address

12 Magnolia St
Easton, MD 21601-3657
Phone (410) 763-6823

Other practice location 1

12 Magnolia St
Easton, MD 21601
Phone (410) 763-6823

Other identifiers 1

IdentifierTypeStateIssuer
1499575MedicaidND

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4911AZMDGeneral Practice Dentistry
2264NDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Red Door Pediatric Therapy, Inc Occupational Therapist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1730462144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 MAGNOLIA ST",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216013657",
            "telephone_number": "410-763-6823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 36TH AVE SW STE 110",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587017597",
            "telephone_number": "701-222-3175",
            "fax_number": "701-222-3186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Magnolia St",
            "address_purpose": "LOCATION",
            "city": "Easton",
            "state": "MD",
            "postal_code": "21601",
            "country_code": "US",
            "telephone_number": "410-763-6823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROFFOOT",
        "first_name": "KRISTEL",
        "middle_name": "DAWN",
        "credential": "M.S., OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "2264",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AZ",
            "license": "4911",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1499575",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.