Active NPI
Kirsten Skundberg, OTR
- Occupational Therapist
- Minnetonka, MN
National Provider Identifier
1760800882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 104677
- Practice address
- 10273 Yellow Circle Dr
Minnetonka, MN 55343-9144 - Phone
- (952) 223-2506
- NPI assigned
- Apr 5, 2014
- 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 | 104677 | MN | Primary |
Addresses
Primary practice location
10273 Yellow Circle Dr
Minnetonka, MN 55343-9144
Mailing address
2270 South Pkwy
Victoria, MN 55386-4538
Phone (952) 223-2506
Other practice location 1
15265 Minnetonka Boulevard
Minnetonka, MN 55345
Phone (952) 223-2506
Other practice location 2
3030 S Jones Blvd Ste 105
Las Vegas, NV 89146-6793
Phone (702) 360-1137
Other practice location 3
3030 S Jones Blvd Ste 105
Las Vegas, NV 89146-6793
Phone (702) 360-1137
Other practice location 4
9346 Oak Ave
Waconia, MN 55387-9422
Phone (952) 223-2506
Other practice location 5
403 Central Ave E Ste 102
Saint Michael, MN 55376-5501
Phone (952) 223-2506
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 |
|---|---|---|---|
| 104677 | MN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663891200000",
"number": "1760800882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2270 SOUTH PKWY",
"city": "VICTORIA",
"state": "MN",
"postal_code": "553864538",
"telephone_number": "952-223-2506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10273 YELLOW CIRCLE DR",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553439144",
"telephone_number": "952-223-2506"
}
],
"practiceLocations": [
{
"address_1": "15265 Minnetonka Boulevard",
"address_purpose": "LOCATION",
"city": "Minnetonka",
"state": "MN",
"postal_code": "55345",
"country_code": "US",
"telephone_number": "952-223-2506",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3030 S Jones Blvd Ste 105",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891466793",
"country_code": "US",
"telephone_number": "702-360-1137",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3030 S Jones Blvd Ste 105",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891466793",
"country_code": "US",
"telephone_number": "702-360-1137",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9346 Oak Ave",
"address_purpose": "LOCATION",
"city": "Waconia",
"state": "MN",
"postal_code": "553879422",
"country_code": "US",
"telephone_number": "952-223-2506",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "403 Central Ave E Ste 102",
"address_purpose": "LOCATION",
"city": "Saint Michael",
"state": "MN",
"postal_code": "553765501",
"country_code": "US",
"telephone_number": "952-223-2506",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SKUNDBERG",
"first_name": "KIRSTEN",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-05",
"last_updated": "2022-09-23",
"certification_date": "2022-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "104677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.