FUNCTIONAL INTEGRATED THERAPY, LTD (NPI# 1477640613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477640613 |
| Entity Type | Organization |
| Organization Name | FUNCTIONAL INTEGRATED THERAPY, LTD |
| Other Organization Name | FUNCTIONAL KIDS CLINIC |
| Practice Address |
2495 Maplewood Drive Suite 313 Maplewood MN 55109-1913 |
| Practice Telephone | 6517708884 |
| Practice Fax Number | 6517708151 |
| Mailing Telephone | 6517708884 |
| Mailing Fax Number | 6517708151 |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2009-03-31 |
| Authorized Official Name | KRISTI KAY WORRELL (OWNER/OPERATOR) |
| Authorized Official Telephone | 6517708884 |
| Authorized Official Credential | OTR/L |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
100591 | MN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BLUE CROSS BLUE SHIELD | 28D39FU | 01 |
| MN | ST PAUL ELECTRICAL WORKER | 36655 | 01 |
| MN | CHOICE PLUS/PATIENT CHOIC | 133343 | 01 |
| MN | UCARE INDIVIDUAL | 181389 | 01 |
| MN | AETNA | 0007336046 | 01 |
| MN | PREFERRED ONE | 18905 | 01 |
| MN | MEDICA | 6401782 | 01 |
| MN | HEALTH PARTNERS | 75732 | 01 |
| MN | 670043800 | 05 | |
| MN | UCARE GROUP | J053 | 01 |
| Other Name | Type Code |
|---|---|
| Functional Kids Clinic | Doing Business As Name - Organization |
| Street Address |
2495 MAPLEWOOD DRIVE SUITE 313 |
| City | MAPLEWOOD |
| State | MN |
| Zip Code | 55109-1913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104154814 | Maria Denise Balsimo | Occupational Therapist | 2495 Maplewood Drive, Suite 313, Maplewood, MN 55109-1913 | 2009-11-19 |
| 1235301532 | Elyse Celine Anderson | Occupational Therapist | 2495 Maplewood Drive, Suite 313, Maplewood, MN 55109-1913 | 2008-03-26 |
| 1740325778 | Mary Martha Clark | Occupational Therapist | 2495 Maplewood Drive, Suite 313, Maplewood, MN 55109-1913 | 2007-02-20 |
| 1568506897 | Kara Ann Schultz | Occupational Therapist | 2495 Maplewood Drive, Suite 313, Maplewood, MN 55109-1913 | 2007-02-19 |
| 1801930482 | Janet Work Stine | Occupational Therapist | 2495 Maplewood Drive, Suite 313, Maplewood, MN 55109-1913 | 2007-02-16 |
| 1992849590 | Janice Kay Herold-maho | Occupational Therapist | 2495 Maplewood Drive, Suite 313, Maplewood, MN 55109-1913 | 2007-02-16 |
| 1942344544 | Kristi Kay Worrell | Occupational Therapist | 2495 Maplewood Drive, Suite 313, Maplewood, MN 55109-1913 | 2007-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063828 | Jodi May Begordis | Registered Nurse | 2586 7th Ave East, Suite 302, North St Paul, MN 55109 | 2020-05-06 |
| 1467917146 | Alejandro Diez Freire | Social Worker | 2468 Germain St, Maplewood, MN 55109 | 2019-02-06 |
| 1679099667 | Rochelle Marie Clarke | Registered Nurse | 2586 7th Ave East Suite 302, North Saint Paul, MN 55109 | 2017-08-21 |
| 1497298210 | Salams Care Residential, LLC | Home Health | 2240 Ide Ct, Maplewood, MN 55109 | 2016-11-28 |
| 1093199630 | Garry Allen | Psychologist | 2345 Ariel St North Mail Stop 13601a, Maplewood, MN 55109 | 2015-07-14 |
| 1700264751 | Matthew Seng Thao | Student in an Organized Health Care Education/Training Program | 1470 Gervais Ave, Maplewood, MN 55109 | 2015-05-11 |
| 1326458340 | Chong Chang | Counselor | 1705 Cope Ave E Ste I, Maplewood, MN 55109 | 2014-04-29 |
| 1619396488 | Leah Anne Downey | Occupational Therapist | 2399 Ariel St. N., Children's Theraplay, LLC, Maplewood, MN 55109 | 2014-04-09 |
| 1356765440 | Group Health Plan, Inc | Clinic/Center | 2520 12th Ave E, North St Paul, MN 55109 | 2014-02-10 |
| 1336560275 | Veneman Dental Care, Pa | Dentist | 1774 Cope Ave, Suite 110, Maplewood, MN 55109 | 2013-12-19 |
| Find all providers in zip 55109 | ||||
| Taxonomy Code | 261QR0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265791503 | Dynamic Connections, Inc. | Clinic/Center | 2495 Maplewood Dr Ste 312, Maplewood, MN 55109-1985 | 2012-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760024756 | Novacare Outpatient Rehabilitation East, Inc. | Clinic/Center | 3960 Coon Rapids Blvd Nw Ste 311, Coon Rapids, MN 55433-2598 | 2019-10-11 |
| 1366084402 | Novacare Outpatient Rehabilitation East, Inc. | Clinic/Center | 16366 County Road 30, Maple Grove, MN 55311-1207 | 2019-10-10 |
| 1427576727 | Ne Community Acupuncture & Wellness Center LLC | Clinic/Center | 1224 2nd St Ne # 200, Minneapolis, MN 55413-1130 | 2017-09-07 |
| 1326589714 | Cognitive Ventures Vadnais Heights LLC | Clinic/Center | 3555 Willow Lake Blvd Ste 180, Vadnais Heights, MN 55110-4462 | 2017-03-17 |
| 1063786689 | River Restorative Therapies LLC | Clinic/Center | 14166 Quince St Nw, Andover, MN 55304-4137 | 2012-02-29 |
| 1013244110 | Muellers Sensory Works LLC | Clinic/Center | 2132 Hoffman Rd, Mankato, MN 56001-5863 | 2009-11-10 |
| 1982842936 | Open Hands Health Services LLC | Clinic/Center | 730 S Benton Dr, Sauk Rapids, MN 56379-1274 | 2009-01-29 |
| 1154577906 | Healthy Returns of Minnesota Inc | Clinic/Center | 20836 Glacier Dr, Park Rapids, MN 56470-5275 | 2008-08-12 |
| 1992986194 | Body Whispers Therapy LLC | Clinic/Center | 3220 Rice St, Saint Paul, MN 55126-3047 | 2007-11-16 |
| 1912004631 | Childrens Health Care | Clinic/Center | 5950 Clearwater Drive, Childrens Hospitals and Clinics Community Rehab, Minnetonka, MN 55343 | 2006-09-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.