Individual provider Active NPI

Amanda Rositas Kjos, OTR/L

  • Occupational Therapist
  • Thief River Falls, MN
National Provider Identifier
1922417880
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
104311 Issued in MN
Practice address
310 Red Lake Blvd Ste B
Thief River Falls, MN 56701-2133
Phone
(218) 416-1482
Fax
(218) 416-1483
NPI assigned
Aug 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 104311 MN Primary

Addresses

Primary practice location

310 Red Lake Blvd Ste B
Thief River Falls, MN 56701-2133

Mailing address

3060 Frontier Way S
Fargo, ND 58104-8909
Phone (701) 232-2340

Other practice location 1

2001 Eastwood Dr
Thief River Falls, MN 56701-4016
Phone (218) 683-8100

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
104311MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Therapy Partners, Inc. Occupational Therapist CurrentSince May 16, 2022 Accepting new patients
Pediatric Therapy Partners, Inc. CurrentSince Apr 24, 2022 Accepting new patients
Pennington Health Services Past Accepting new patients
Hospice of the Red River Valley Past Accepting new patients

Locations

310 Red Lake Blvd
Ste B
Thief River Falls, MN 56701
Phone (218) 416-1482

419 Atlantic Ave
Thief River Falls, MN 56701
Phone (218) 416-1482

3060 Frontier Way S
Fargo, ND 58104
Phone (701) 356-4384

1811 S Washington St
Grand Forks, ND 58201
Phone (701) 757-3045

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1922417880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 FRONTIER WAY S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048909",
            "telephone_number": "701-232-2340",
            "fax_number": "701-232-2340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 RED LAKE BLVD STE B",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567012133",
            "telephone_number": "218-416-1482",
            "fax_number": "218-416-1483"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 Eastwood Dr",
            "address_purpose": "LOCATION",
            "city": "Thief River Falls",
            "state": "MN",
            "postal_code": "567014016",
            "country_code": "US",
            "telephone_number": "218-683-8100",
            "fax_number": "320-683-8130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSITAS KJOS",
        "first_name": "AMANDA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "104311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thief River Falls, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.