MEMORY DISORDERS CLINIC (NPI# 1871700088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871700088 |
| Entity Type | Organization |
| Organization Name | MEMORY DISORDERS CLINIC |
| Practice Address |
1245 15th St N Saint Cloud MN 56303-1802 |
| Mailing Address |
10915 264th St Saint Cloud MN 56301-9411 |
| Practice Telephone | 3202032093 |
| Mailing Telephone | 3202932128 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. SANDRA WENNER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3202032000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | 100395 | MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1245 15TH ST N |
| City | SAINT CLOUD |
| State | MN |
| Zip Code | 56303-1802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225017734 | Nicole E Peterson | Physical Therapist | 1245 15th St N, Saint Cloud, MN 56303-1802 | 2006-01-12 |
| 1134389778 | Robert Paul Himmerick | Physical Therapist | 1245 15th St N, Saint Cloud, MN 56303-1802 | 2008-06-16 |
| 1780855155 | Novacare Outpatient Rehabilitation East Inc | Durable Medical Equipment & Medical Supplies | 1245 15th St N, N, Saint Cloud, MN 56303-1802 | 2008-03-13 |
| 1881863124 | Cassandra A. Amiot | Physician Assistant | 1245 15th St N, Saint Cloud, MN 56303-1802 | 2008-02-20 |
| 1578747085 | Ellen B Ellickson | Nurse Practitioner | 1245 15th St N, Saint Cloud, MN 56303-1802 | 2007-12-19 |
| 1437359817 | Lois Schueller Roback | Social Worker | 1245 15th St N, Saint Cloud, MN 56303-1802 | 2007-07-23 |
| 1528268901 | Denis Mcguinness | Social Worker | 1245 15th St N, Saint Cloud, MN 56303-1802 | 2007-07-23 |
| 1487857249 | Pam J. Waage | Nurse Practitioner | 1245 15th St N, Saint Cloud, MN 56303-1802 | 2007-06-08 |
| 1316140718 | Central Minnesota Group Health, Inc | Durable Medical Equipment & Medical Supplies | 1245 15th St N, Saint Cloud, MN 56303-1802 | 2007-06-06 |
| 1669547279 | Valerie Broste | Marriage & Family Therapist | 1245 15th St N, Saint Cloud, MN 56303-1802 | 2006-11-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164661 | Pathways Therapy Services LLC | Occupational Therapist | 4417 13th St # 159, Saint Cloud, FL 34769-6724 | 2020-11-04 |
| 1932665361 | Alison Host | Occupational Therapist | 3318 Topaz Pkwy S, Saint Cloud, MN 56301-5865 | 2019-02-11 |
| 1578924411 | Kate Breuer | Occupational Therapist | 2835 W Saint Germain St # 300, Saint Cloud, MN 56301-6280 | 2016-03-18 |
| 1447693148 | David Mark Hennen | Occupational Therapist | 11612 260th St, Saint Cloud, MN 56301-9409 | 2013-04-11 |
| 1285900571 | Maleah Kay Knigge | Occupational Therapist | 3315 Roosevelt Rd, Ste 200a, Saint Cloud, MN 56301-9737 | 2012-03-30 |
| 1487953139 | Alishia Minzel | Occupational Therapist | 6100 Westwood Pkwy Apt 321, Saint Cloud, MN 56303-0243 | 2011-03-21 |
| 1487971347 | Grisel Plenge | Occupational Therapist | 2819 Mosshire Cir, Saint Cloud, FL 34772-3603 | 2010-04-30 |
| 1679732358 | Kayla Zylla | Occupational Therapist | 1900 Centracare Cir Ste 1000, Saint Cloud, MN 56303-5000 | 2008-06-06 |
| 1033216189 | Denise A Comiskey | Occupational Therapist | 4417 13th St, Ste 159, Saint Cloud, FL 34769-6724 | 2006-09-20 |
| 1245831007 | Tracy Scharfbillig | Occupational Therapist | 2835 W Saint Germain St Ste 300, Saint Cloud, MN 56301-6281 | 2020-11-06 |
| Find all providers in SAINT CLOUD | ||||
| City | SAINT CLOUD |
| Zip Code | 56303 |
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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.