Individual provider Active NPI

Richard Joshua Mester, COTA/L

  • Occupational Therapy Assistant
  • St Louis Park, MN
National Provider Identifier
1952729246
Registry record updated Apr 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
201917 Issued in MN
Practice address
4415 W 36 1/2 St
St Louis Park, MN 55416-4854
Phone
(952) 927-9717
Fax
(952) 927-7687
NPI assigned
Apr 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 201917 MN Primary

Addresses

Primary practice location

4415 W 36 1/2 St
St Louis Park, MN 55416-4854

Mailing address

4415 W 36 1/2 St
St Louis Park, MN 55416-4854
Phone (952) 927-9717

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
201917MNMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396483200000",
    "number": "1952729246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 W 36 1/2 ST",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164854",
            "telephone_number": "952-927-9717",
            "fax_number": "952-927-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 W 36 1/2 ST",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164854",
            "telephone_number": "952-927-9717",
            "fax_number": "952-927-7687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESTER",
        "first_name": "RICHARD",
        "middle_name": "JOSHUA",
        "name_prefix": "Mr.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-03",
        "last_updated": "2014-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MN",
            "license": "201917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; 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.