NPIMap

Organization Active NPI

Great River Therapy Inc

  • Physical Therapist
  • Red Wing, MN
National Provider Identifier
1003128869
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1490 Issued in MN
Legal business name
GREAT RIVER THERAPY INC
Practice address
416 W 3Rd St
Red Wing, MN 55066-2384
Phone
(651) 388-7511
Fax
(651) 388-2369
NPI assigned
Jul 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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

Authorized official

Name
Erik Ramsey Gram, PTNPI 1205921913
Title
President
Phone
(651) 388-7511

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 1490 MN Primary

Addresses

Primary practice location

416 W 3Rd St
Red Wing, MN 55066-2384

Mailing address

416 W 3Rd St
Red Wing, MN 55066-2384
Phone (651) 388-7511

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278633600000",
    "number": "1003128869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 W 3RD ST",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550662384",
            "telephone_number": "651-388-7511",
            "fax_number": "651-388-2369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 W 3RD ST",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550662384",
            "telephone_number": "651-388-7511",
            "fax_number": "651-388-2369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT RIVER THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-09",
        "last_updated": "2010-07-09",
        "status": "A",
        "authorized_official_last_name": "GRAM",
        "authorized_official_first_name": "ERIK",
        "authorized_official_middle_name": "RAMSEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-388-7511",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "1490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Wing, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.