Individual provider Active NPI

Julie Kay Henderson, OTL, CHT

  • Hand Occupational Therapist
  • Coon Rapids, MN
National Provider Identifier
1881719003
Registry record updated Apr 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
100914 Issued in MN
Practice address
11850 Blackfoot St NW Ste 400
Coon Rapids, MN 55433-2776
Phone
(763) 236-8911
Fax
(763) 236-8930
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 100914 MN Primary

Addresses

Primary practice location

11850 Blackfoot St NW Ste 400
Coon Rapids, MN 55433-2776

Mailing address

13514 Acacia Ave NE
Monticello, MN 55362-3249
Phone (763) 878-1648

Other practice location 1

3111 124th Ave NW
Coon Rapids, MN 55433-1793
Phone (763) 236-8948

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
100914MNMDHand Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1881719003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13514 ACACIA AVE NE",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553623249",
            "telephone_number": "763-878-1648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11850 BLACKFOOT ST NW STE 400",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332776",
            "telephone_number": "763-236-8911",
            "fax_number": "763-236-8930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3111 124th Ave NW",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554331793",
            "country_code": "US",
            "telephone_number": "763-236-8948",
            "fax_number": "763-236-8930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JULIE",
        "middle_name": "KAY",
        "name_prefix": "Mr.",
        "credential": "OTL, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "MN",
            "license": "100914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.