Alexis Marie Hanevold, O.T

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

106041 Issued in MN

Practice address

625 Demers Ave
East Grand Forks, MN 56721-1833

Phone

(218) 773-5858

NPI assigned

Sep 8, 2019

Last updated

Feb 13, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN, ND2 enrollments

Enrollment records 2

Specialty

Occupational Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

82.73 of 100Reported as group

Quality

71.75

Promoting interoperability

100

Improvement activities

40

Cost

70.68

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sanford Medical Center Fargo

  dba Sanford 1717 Medical Building

  • Family Medicine Physician
  • West Fargo, ND
  • NPI 1184917924

  MN, Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Sanford Medical Center Fargo

  dba Sanford POWER Center

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1528009412
  NPD
• Sanford Clinic North

  dba Sanford Health Detroit Lakes Clinic

  • Internal Medicine Physician
  • Detroit Lakes, MN
  • NPI 1235170747
  NPD (past)

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

{
    "created_epoch": "1567900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1841849320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 DEMERS AVE",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "567211833",
            "telephone_number": "218-773-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANEVOLD",
        "first_name": "ALEXIS",
        "middle_name": "MARIE",
        "credential": "O.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-08",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "1738",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "106041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "625 DeMers Ave",
            "city": "East Grand Forks",
            "state": "MN",
            "country_code": "US",
            "postal_code": "567211833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dorothy Gomez
• Mathew T Grasser, PT
• Callie J Greene, DPT
• Denae D Grove, LRD
• Lisa Gunderson, PHARMD
• Jeffrey S Haney, PT
• Christine Hanson, APRN, PMHNP-BC
• Erica Hilda Hanson, PT
• Jessica Kimberly Hartman, LCSW/LICSW
• Holli Hauger

• Occupational Therapist in East Grand Forks, MN
• Providers in East Grand Forks, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.