Individual provider Active NPI

Olivia Rose Woodward

  • Behavior Technician
  • Bloomington, MN
National Provider Identifier
1891440558
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1801 American Blvd E Ste 8
Bloomington, MN 55425-1230
Phone
(952) 767-2267
NPI assigned
Feb 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

1801 American Blvd E Ste 8
Bloomington, MN 55425-1230

Mailing address

4701 Emerson Ave S
Minneapolis, MN 55419-5329
Phone (612) 704-3231

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fraser Child and Family Center CurrentSince Oct 9, 2023 Accepting new patients
Fraser PastSince Feb 27, 2022 Accepting new patients

Locations

1801 American Blvd E
Ste 8
Minneapolis, MN 55425
Phone (612) 400-6173

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1891440558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 EMERSON AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554195329",
            "telephone_number": "612-704-3231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 AMERICAN BLVD E STE 8",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251230",
            "telephone_number": "952-767-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODWARD",
        "first_name": "OLIVIA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-21",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; 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.