Active NPI
Ronald William Neva, PT
- Physical Therapist
- Moose Lake, MN
National Provider Identifier
1063665503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5148
- Practice address
- 710 S Kenwood Ave
Moose Lake, MN 55767-9405 - Phone
- (218) 485-5516
- Fax
- (218) 485-5865
- NPI assigned
- Oct 28, 2008
- Last updated
- Oct 28, 2008
- Sex
- Male
- 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 | 5148 | MN | Primary |
Addresses
Primary practice location
710 S Kenwood Ave
Moose Lake, MN 55767-9405
Mailing address
710 S Kenwood Ave
Moose Lake, MN 55767-9405
Phone (218) 485-5516
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5148 | MN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225152000000",
"number": "1063665503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 S KENWOOD AVE",
"city": "MOOSE LAKE",
"state": "MN",
"postal_code": "557679405",
"telephone_number": "218-485-5516",
"fax_number": "218-485-5865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 S KENWOOD AVE",
"city": "MOOSE LAKE",
"state": "MN",
"postal_code": "557679405",
"telephone_number": "218-485-5516",
"fax_number": "218-485-5865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEVA",
"first_name": "RONALD",
"middle_name": "WILLIAM",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-10-28",
"last_updated": "2008-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "5148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moose Lake, MN
- Moose Lake Community Hospital District (Mercy Hospital)
- Moose Lake Eye Care LLC
- Msocs-Moose Lake
- Jacob C Nelson, PHARMD
- Maggie Beth Neudecker, MD
- Scott Nielsen, MA, CPRP
- Glenn H. Nordehn, D.O.
- Northern Lakes Surgery Center LLC (Northern Lake Surgery Center DME)
- Northern Lakes Surgery Center LLC
- Northern Lakes Surgery Center LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.