Active NPI
Lisa Nelezen
- Physical Therapist
- Minnetonka, MN
National Provider Identifier
1013127091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2463
- Practice address
- 2713 Autumnwood LN
Minnetonka, MN 55305-3488 - Phone
- (952) 593-1592
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2463 | MN | Primary |
Addresses
Primary practice location
2713 Autumnwood LN
Minnetonka, MN 55305-3488
Mailing address
2713 Autumnwood LN
Minnetonka, MN 55305-3488
Phone (952) 593-1592
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2463 | MN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013127091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2713 AUTUMNWOOD LN",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553053488",
"telephone_number": "952-593-1592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2713 AUTUMNWOOD LN",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553053488",
"telephone_number": "952-593-1592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELEZEN",
"first_name": "LISA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "2463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.