Kelly Eckert

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

107099 Issued in MN

Practice address

14635 Pennock Ave Ste 300
Apple Valley, MN 55124-6588

Phone

(651) 994-9644

Fax

(651) 994-8962

NPI assigned

Mar 8, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Children'S Therapy Center, Inc

  • Speech-Language Pathologist
  • Eagan, MN
  • NPI 1295809366

  MN, Occupational Therapist

  Medicare reassignment NPD
• Children'S Therapy Ctr, Inc

  • Speech-Language Pathologist
  • Apple Valley, MN
  • NPI 1053450742
  NPD (past)

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

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1982304945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2795 PILOT KNOB RD STE 100",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211930",
            "telephone_number": "651-994-9644",
            "fax_number": "651-994-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14635 PENNOCK AVE STE 300",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246588",
            "telephone_number": "651-994-9644",
            "fax_number": "651-994-8962"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2795 Pilot Knob Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "551211930",
            "country_code": "US",
            "telephone_number": "651-994-9644",
            "fax_number": "651-994-8962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ECKERT",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-08",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "107099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eagan Valley Dental Center
• Eagan Valley Pediatrics, P.a.
• East Valleydental, PA
• Ashley Ebeling, PT, DPT
• Sally Ebeling
• Ecumen
• Ecumen
• Elite Dental, LLC
• Ellen Weis Chiropractic LLC
• Devon Simone Ellena, NP

• All providers in Apple Valley, MN
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.