Kelly Erin Deweese, MOT, ORT/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

103602 Issued in MN

Practice address

900 West 94TH Street
Bloomington, MN 55420

Phone

(952) 885-0418

Fax

(952) 885-0173

NPI assigned

Aug 13, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Family Achievement Center Inc.

  • Occupational Therapist
  • Woodbury, MN
  • NPI 1952411175
  NPD (past)
• The Therapy Place

  • Rehabilitation Clinic/Center
  • Bloomington, MN
  • NPI 1609934173
  NPD (past)

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245283200000",
    "number": "1851547582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 WEST 94TH STREET",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "55420",
            "telephone_number": "952-885-0418",
            "fax_number": "952-885-0173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WEST 94TH STREET",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "55420",
            "telephone_number": "952-885-0418",
            "fax_number": "952-885-0173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWEESE",
        "first_name": "KELLY",
        "middle_name": "ERIN",
        "credential": "MOT, ORT/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-13",
        "last_updated": "2009-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "103602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destiny Home Care
• Dane Detert
• Jodi Detoffol, SLP
• Amrit Devgun, N.D.
• Renee Marie Devries, D.C.
• Adam James Dewenter, MOT, OTR/L
• Samira Dhere
• Sirah Grace Diaby
• Allison Diaz
• Frances Diaz, LICENSED MASSAGE THE

• Occupational Therapist in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; 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.