Individual provider Active NPI

Brianna Carpenter

  • Occupational Therapist
  • Eagan, MN
National Provider Identifier
1740046879
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
107391 Issued in MN
Practice address
2795 Pilot Knob Rd Ste 100
Eagan, MN 55121-1930
Phone
(651) 994-9644
NPI assigned
Feb 26, 2024
Last updated
Feb 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 107391 MN Primary

Addresses

Primary practice location

2795 Pilot Knob Rd Ste 100
Eagan, MN 55121-1930

Mailing address

2795 Pilot Knob Rd Ste 100
Eagan, MN 55121-1930

Other practice location 1

14635 Pennock Ave Ste 300
Apple Valley, MN 55124-6588
Phone (651) 994-9644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240312001613 MN Practitioner - Occupational Therapist in Private Practice 8123464237 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107391MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Therapy Center, Inc Occupational Therapist CurrentSince Jan 28, 2024 Accepting new patients
Children's Therapy Ctr, Inc PastSince Jan 28, 2024 Accepting new patients

Locations

14635 Pennock Ave
Ste 300
Apple Valley, MN 55124
Phone (651) 994-9644

2795 Pilot Knob Rd
Ste 100
Saint Paul, MN 55121
Phone (651) 994-9644

Organizations & group practices 2

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": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1740046879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2795 PILOT KNOB RD STE 100",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2795 PILOT KNOB RD STE 100",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211930",
            "telephone_number": "651-994-9644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14635 Pennock Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "MN",
            "postal_code": "551246588",
            "country_code": "US",
            "telephone_number": "651-994-9644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "BRIANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "107391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.