Active NPI
Jeremy Martin
- Physical Therapist
- Richfield, MN
National Provider Identifier
1083522577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10031
- Practice address
- 6625 Lyndale Ave S Ste 430
Richfield, MN 55423-2300 - Phone
- (952) 285-2840
- Fax
- (952) 285-2830
- NPI assigned
- Aug 27, 2026
- Sex
- Male
- 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 | 10031 | MN | Primary |
Addresses
Primary practice location
6625 Lyndale Ave S Ste 430
Richfield, MN 55423-2300
Mailing address
12971 Ardroe Ave
Rosemount, MN 55068-4835
Phone (320) 510-0892
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10031 | Other | MN | STATE OF MN BOARD OF PT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787788800000",
"number": "1083522577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12971 ARDROE AVE",
"city": "ROSEMOUNT",
"state": "MN",
"postal_code": "550684835",
"telephone_number": "320-510-0892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6625 LYNDALE AVE S STE 430",
"city": "RICHFIELD",
"state": "MN",
"postal_code": "554232300",
"telephone_number": "952-285-2840",
"fax_number": "952-285-2830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "JEREMY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-08-27",
"last_updated": "2026-08-27",
"certification_date": "2026-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "MN",
"license": "10031",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF MN BOARD OF PT",
"identifier": "10031",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richfield, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.