Samantha Thayer, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

104958 Issued in MN

Practice address

320 Coon Rapids Blvd NW Ste 100
Coon Rapids, MN 55433-5640

Phone

(952) 908-2580

NPI assigned

Sep 10, 2015

Last updated

Feb 9, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

• Interventional Spine and Pain Physicians, PA

  • Specialist
  • Maple Grove, MN
  • NPI 1326398561

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454976000000",
    "number": "1871961532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2443 3RD AVE S APT C13",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043519",
            "telephone_number": "651-260-1299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 COON RAPIDS BLVD NW STE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335640",
            "telephone_number": "952-908-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAYER",
        "first_name": "SAMANTHA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-10",
        "last_updated": "2016-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "104958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Ellen Tessmer
• Erin Withers Thackeray, MD
• Andrew Thao
• Ching Yeng Thao
• Edwin Ma Thao
• The Fountains Living LLC
• The Homestead at Coon Rapids, Inc.
• The Homestead at Coon Rapids, Inc. (The Homestead at Coon Rapids)
• The Menage
• The Winkley Company (Winkley Orthotics and Prosthetics)

• Occupational Therapist in Coon Rapids, MN
• Providers in Coon Rapids, 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 9, 2016; 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.