Active NPI
Autumn Ronglien
- Occupational Therapist
- Madison, MN
National Provider Identifier
1962793653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 103972
- Practice address
- 900 2ND Ave Ste 704
Madison, MN 56256-1006 - Phone
- (132) 069-8716
- NPI assigned
- Apr 28, 2011
- Last updated
- Jul 18, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 103972 | MN | Primary |
Addresses
Primary practice location
900 2ND Ave Ste 704
Madison, MN 56256-1006
Mailing address
900 2ND Ave
Madison, MN 56256-1006
Phone (132) 069-8716
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
| License | State | Type | Specialty |
|---|---|---|---|
| 103972 | MN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689638400000",
"number": "1962793653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 2ND AVE",
"city": "MADISON",
"state": "MN",
"postal_code": "562561006",
"telephone_number": "132-069-8716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 2ND AVE STE 704",
"city": "MADISON",
"state": "MN",
"postal_code": "562561006",
"telephone_number": "132-069-8716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RONGLIEN",
"first_name": "AUTUMN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-28",
"last_updated": "2023-07-18",
"certification_date": "2023-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "103972",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.