Alexis Kim, OTR/L – Occupational Therapist

Key facts

NPI: 1871963223
Entity type: Individual (NPI type 1)
Primary specialty: Occupational Therapist 225X00000X
License: 104158 (MN)
Practice address: 1879 Feronia Ave
Saint Paul, MN 55104-3549
Phone: (651) 333-0785
NPI assigned: Sep 28, 2015
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Rehabcare Group East Inc. Physical Disabilities Residential Treatment Facility · Louisville, KY · NPI 1366810434

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
002272	IA	MD	Occupational Therapist
104158	MN	MD	Occupational Therapist

Practice roles

Organization	Specialty	Status	New patients
Rehabcare Group East Inc.		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Occupational Therapist	225X00000X	104158	MN	Yes
Occupational Therapist	225X00000X	002272	IA

Addresses

Primary practice location

1879 Feronia Ave
Saint Paul, MN 55104-3549

Mailing address

7408 Edgewood Ave N
Brooklyn Park, MN 55428-1440
Phone (651) 333-0785

Other providers in Saint Paul, MN

All providers in Saint Paul, MN · Occupational Therapist in Minnesota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2015. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.