Active NPI
Frederick Carl Hjelm, P.T.
- Physical Therapist
- Roseville, MN
National Provider Identifier
1083707046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4060
- Practice address
- 1835 County Road C W
Roseville, MN 55113-1352 - Phone
- (651) 638-0080
- Fax
- (651) 638-0082
- NPI assigned
- Oct 2, 2006
- 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 | 4060 | MN | Primary |
Addresses
Primary practice location
1835 County Road C W
Roseville, MN 55113-1352
Mailing address
7700 Highway 65 NE
Spring Lake Park, MN 55432-2832
Phone (763) 784-3155
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5873789-00 | Medicaid | MN |
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 |
|---|---|---|---|
| 4060 | MN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multicenter Physical Therapy, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapy Clinic/Center
- Spring Lake Park, MN
- NPI 1346287158
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224547200000",
"number": "1083707046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7700 HIGHWAY 65 NE",
"city": "SPRING LAKE PARK",
"state": "MN",
"postal_code": "554322832",
"telephone_number": "763-784-3155",
"fax_number": "763-784-2352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1835 COUNTY ROAD C W",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551131352",
"telephone_number": "651-638-0080",
"fax_number": "651-638-0082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HJELM",
"first_name": "FREDERICK",
"middle_name": "CARL",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2008-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "4060",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5873789-00",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roseville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.