Individual provider Active NPI

Amanda Struxness, OTR

  • Occupational Therapist
  • Virginia, MN
National Provider Identifier
1831271253
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
102418 Issued in MN
Practice address
130 Anderson Dr Apt 8
Virginia, MN 55792-3562
Phone
(218) 503-0171
NPI assigned
Oct 19, 2006
Last updated
May 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5033-026 WI
Occupational Therapist 225X00000X 102418 MN Primary

Addresses

Primary practice location

130 Anderson Dr Apt 8
Virginia, MN 55792-3562

Mailing address

130 Anderson Dr Apt 8
Virginia, MN 55792-3562
Phone (218) 503-0171

Other practice location 1

4808 92nd Ct
Brooklyn Park, MN 55443-1655
Phone (218) 503-0171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231221003987 MN Practitioner - Occupational Therapist in Private Practice 8628203080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crescent Moon CounselingGroup PAC ID 3476920646, 6 clinicians

Practice addresses (Care Compare)

820 N 9TH St
Virginia, MN 55793
Phone (218) 248-2402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
102418MNMDOccupational Therapist
5033-026WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Crescent Moon Counseling CurrentSince Jun 18, 2025 Accepting new patients
Lakeshore Family Therapy LLC PastSince Jun 18, 2025 Accepting new patients

Locations

820 9th St N
Virginia, MN 55792
Phone (218) 248-2402

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1831271253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 ANDERSON DR APT 8",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557923562",
            "telephone_number": "218-503-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 ANDERSON DR APT 8",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557923562",
            "telephone_number": "218-503-0171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4808 92nd Ct",
            "address_purpose": "LOCATION",
            "city": "Brooklyn Park",
            "state": "MN",
            "postal_code": "554431655",
            "country_code": "US",
            "telephone_number": "218-503-0171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STRUXNESS",
        "first_name": "AMANDA",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "5033-026",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "102418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; 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.