Active NPI
Molly Reese Schultz, PT
- Physical Therapy Clinic/Center
- Maplewood, MN
National Provider Identifier
1063840403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- License
- 8636
- Practice address
- 1747 Beam Ave
Maplewood, MN 55109-1128 - Phone
- (651) 326-5569
- NPI assigned
- Oct 22, 2013
- 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 Therapy Clinic/Center | 261QP2000X | 8636 | MN | Primary |
Addresses
Primary practice location
1747 Beam Ave
Maplewood, MN 55109-1128
Mailing address
3707 Grand Way Apt 301
St Louis Park, MN 55416-2754
Phone (952) 905-6059
Other names 1
- Molly Reese Nelson
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1382400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649116800000",
"number": "1063840403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3707 GRAND WAY APT 301",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554162754",
"telephone_number": "952-905-6059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1747 BEAM AVE",
"city": "MAPLEWOOD",
"state": "MN",
"postal_code": "551091128",
"telephone_number": "651-326-5569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHULTZ",
"first_name": "MOLLY",
"middle_name": "REESE",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-10-22",
"last_updated": "2022-04-05",
"certification_date": "2022-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": "MN",
"license": "8636",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MOLLY",
"last_name": "NELSON",
"middle_name": "REESE",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Maplewood, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.