Individual provider Active NPI

Whitney Harris, OTRL

  • Pediatric Occupational Therapist
  • Edina, MN
National Provider Identifier
1801386115
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
107078 Issued in MN
Practice address
3300 Edinborough Way Ste 207
Edina, MN 55435-6001
Phone
(952) 204-5523
NPI assigned
May 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 18694 CA
Pediatric Occupational Therapist 225XP0200X 107078 MN Primary

Addresses

Primary practice location

3300 Edinborough Way Ste 207
Edina, MN 55435-6001

Mailing address

1169 Meadowbrook Rd
Altadena, CA 91001-3133
Phone (323) 644-9380

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

State licenses

LicenseStateTypeSpecialty
107078MNMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Journey Pediatric Therapy LLC CurrentSince May 21, 2023 Accepting new patients
Smile Pediatric Speech Therapy & Diagnostics Inc. PastSince May 22, 2022 Accepting new patients
Capernaum Pediatric Therapy, Inc. Past Accepting new patients

Locations

3300 Edinborough Way
Ste 207
Edina, MN 55435
Phone (952) 204-5523

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1801386115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1169 MEADOWBROOK RD",
            "city": "ALTADENA",
            "state": "CA",
            "postal_code": "910013133",
            "telephone_number": "323-644-9380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 EDINBOROUGH WAY STE 207",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554356001",
            "telephone_number": "952-204-5523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "WHITNEY",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-11",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "18694",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MN",
            "license": "107078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; 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.