Taylor Ann Koopmeiners

Individual provider Active NPI Occupational Therapist · Eden Valley, MN

NPI 1801412366 · NPPES record last updated Sep 6, 2024

Key facts

NPI
1801412366
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
6092 (MN)
Practice address
298 Brooks St N
Eden Valley, MN 55329-1209
Phone
(320) 453-2990
NPI assigned
Jun 21, 2020
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6092MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northway Academy, Inc. Past
since Jun 1, 2020
Accepting new patients
Northway Academy, Inc. Past
since Jun 1, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Occupational Therapist 225X00000X 6092 MN Yes

Addresses

Primary practice location

298 Brooks St N
Eden Valley, MN 55329-1209

Mailing address

298 Brooks St N
Eden Valley, MN 55329-1209
Phone (320) 453-2990

Other practice location 1

108 Doctors Park
Saint Cloud, MN 56303-1207
Phone (320) 774-3915

Other practice location 2

205 14th Ave E
Sartell, MN 56377-4500
Phone (320) 774-3436

Other providers in Eden Valley, MN

All providers in Eden Valley, MN · Occupational Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.