Nicole Rose Huelsman, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

105273

Practice address

413 13TH Ave
Howard Lake, MN 55349-9409

Phone

(320) 543-3800

NPI assigned

Oct 30, 2017

Sex

Female

Sole proprietor

No

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

• Roots and Wings Therapeutic Services LLC

  • Occupational Therapist
  • Rogers, MN
  • NPI 1902564420

  MN, Occupational Therapist

  Medicare reassignment Care Compare group NPD

Specialty

Occupational Therapist in Private Practice

Education

University of Minnesota Medical School, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Roots and Wings Therapeutic Services LLC 6 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 16, 2018.

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1780196899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 13TH AVE",
            "city": "HOWARD LAKE",
            "state": "MN",
            "postal_code": "553499409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 13TH AVE",
            "city": "HOWARD LAKE",
            "state": "MN",
            "postal_code": "553499409",
            "telephone_number": "320-543-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUELSMAN",
        "first_name": "NICOLE",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-30",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": "105273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Howard Lake, MN
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.

Verify at the official NPI Registry.