Active NPI
Sara Lynne Kneisl, D.P.T.
- Physical Therapist
- Princeton, MN
National Provider Identifier
1013167709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 8180
- Practice address
- 911 Northland Dr
Princeton, MN 55371-2172 - Phone
- (763) 389-6420
- Fax
- (763) 389-6410
- NPI assigned
- Sep 30, 2008
- Sex
- Female
- Sole proprietor
- No
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 | 8180 | MN | Primary |
Addresses
Primary practice location
911 Northland Dr
Princeton, MN 55371-2172
Mailing address
911 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-6420
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6409269 | Other | MN | MEDICA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930021628 | MN | DME Supplier - Independently-Practicing Physical Therapist | 3577566496 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Baxter, MN |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8180 | MN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383177600000",
"number": "1013167709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "911 NORTHLAND DR",
"city": "PRINCETON",
"state": "MN",
"postal_code": "553712172",
"telephone_number": "763-389-6420",
"fax_number": "763-389-6410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "911 NORTHLAND DR",
"city": "PRINCETON",
"state": "MN",
"postal_code": "553712172",
"telephone_number": "763-389-6420",
"fax_number": "763-389-6410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNEISL",
"first_name": "SARA",
"middle_name": "LYNNE",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-30",
"last_updated": "2013-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "8180",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "6409269",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Princeton, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2013; 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.