Active NPI
Anneka Roderick, MS, OTR/L
- Occupational Therapist
- Granite Falls, MN
National Provider Identifier
1750960845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2533
- Practice address
- 345 10TH Ave
Granite Falls, MN 56241-1442 - Phone
- (320) 564-6243
- NPI assigned
- Apr 6, 2021
- Last updated
- Aug 13, 2024
- Sex
- Female
- Sole proprietor
- No
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 | 2533 | NE | Primary |
Addresses
Primary practice location
345 10TH Ave
Granite Falls, MN 56241-1442
Mailing address
11500 Wayzata Blvd # 1074
Minnetonka, MN 55305-2007
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2533 | NE | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723507200000",
"number": "1750960845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11500 WAYZATA BLVD # 1074",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553052007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 10TH AVE",
"city": "GRANITE FALLS",
"state": "MN",
"postal_code": "562411442",
"telephone_number": "320-564-6243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODERICK",
"first_name": "ANNEKA",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-06",
"last_updated": "2024-08-13",
"certification_date": "2024-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NE",
"license": "2533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Granite Falls, MN
- Susan Elaine Peterson-Bones, LICSW
- Vickie Lynn Potter, M.S., L.P.
- Reverence for Life and Concern for People Inc (Proejct Turnabout)
- Arthur J Rillo, MD
- Rosa Esmeralda Rios Avendano, M.D.
- Tamala Schmitz, CNP
- Julie Elizabeth Shourds, DC
- Slater Surgical, LLC
- Angela Fay Smith, NURSE PRACTITIONER
- Kyndall Sneller, M.S., CF-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.