NPIMap

Organization Active NPI

Blossom Pediatric Therapy, LLC

  • Pediatric Occupational Therapist
  • Lenexa, KS
National Provider Identifier
1831614908
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
17-03143 Issued in KS
Legal business name
BLOSSOM PEDIATRIC THERAPY, LLC
Practice address
12351 W 96TH Ter Ste 105
Lenexa, KS 66215-4410
Phone
(913) 299-4855
Fax
(888) 965-8977
NPI assigned
Aug 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Jennifer J Minnis, MOTR/L
Title
Occupational Therapist
Phone
(913) 299-4855

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X 17-03143 KS Primary

Addresses

Primary practice location

12351 W 96TH Ter Ste 105
Lenexa, KS 66215-4410

Mailing address

12351 W 96TH Ter Ste 105
Lenexa, KS 66215-4410
Phone (913) 299-4855

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1831614908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12351 W 96TH TER STE 105",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662154410",
            "telephone_number": "913-299-4855",
            "fax_number": "888-965-8977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12351 W 96TH TER STE 105",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662154410",
            "telephone_number": "913-299-4855",
            "fax_number": "888-965-8977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM PEDIATRIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-09",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MINNIS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "913-299-4855",
        "authorized_official_credential": "MOTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "KS",
            "license": "17-03143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenexa, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.

Verify at the official NPI Registry.