Individual provider Active NPI

Crystal Marie Luxmore, M.A. IN P.T.

  • Orthopedic Physical Therapist
  • Minneapolis, MN
National Provider Identifier
1063617306
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
7162 Issued in MN
Practice address
2400 W 64TH St
Minneapolis, MN 55423-1001
Phone
(612) 798-8339
NPI assigned
Jun 18, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7162 MN
Neurology Physical Therapist 2251N0400X 7162 MN
Pediatric Physical Therapist 2251P0200X 7162 MN
Orthopedic Physical Therapist 2251X0800X 7162 MN Primary

Addresses

Primary practice location

2400 W 64TH St
Minneapolis, MN 55423-1001

Mailing address

70 Todd St
New Market, MN 55054-5452
Phone (612) 798-8339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040223000400 MN Practitioner - Physical Therapist in Private Practice 3173419710 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Chiropractic and Wellness PAGroup PAC ID 7012007719, 3 clinicians

Practice addresses (Care Compare)

17502 Dodd Blvd
Lakeville, MN 55044-5268
Phone (952) 431-7400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
7162MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inver Grove Chiropractic P a CurrentSince Dec 10, 2019 Accepting new patients
Family Chiropractic and Wellness, P.a. CurrentSince May 20, 2015 Accepting new patients
Fraser Past Accepting new patients
Fraser Child and Family Center PastSince Oct 28, 2020 Accepting new patients

Locations

2940 65th St E
Inver Grove Heights, MN 55076
Phone (651) 451-1012

17502 Dodd Blvd
Lakeville, MN 55044
Phone (952) 431-7274

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1063617306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 TODD ST",
            "city": "NEW MARKET",
            "state": "MN",
            "postal_code": "550545452",
            "telephone_number": "612-798-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 W 64TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554231001",
            "telephone_number": "612-798-8339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUXMORE",
        "first_name": "CRYSTAL",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "M.A. IN P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "7162",
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "MN",
            "license": "7162",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "MN",
            "license": "7162",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MN",
            "license": "7162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.