Renee Joann Mader, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A206 Issued in MN

Practice address

14655 Galaxie Aveune
Apple Valley, MN 55124-8575

Phone

(651) 241-3880

Fax

(651) 241-3890

NPI assigned

Feb 8, 2012

Last updated

Feb 8, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1093087991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14655 GALAXIE AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551248575",
            "telephone_number": "651-241-3880",
            "fax_number": "651-241-3890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14655 GALAXIE AVEUNE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551248575",
            "telephone_number": "651-241-3880",
            "fax_number": "651-241-3890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADER",
        "first_name": "RENEE",
        "middle_name": "JOANN",
        "name_prefix": "Miss",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-08",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MN",
            "license": "A206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luxottica of America Inc. (Target Optical #1940)
• Danielle M Lyons
• David Ven Maas, M.D.
• Susan W Macharia
• David Archibald Macnaughton, MA, LMFT
• Sumaya Mustafe Mahdi
• Erica Lee Mahlum, PA-C
• Making the Connection
• Brandon Mannie, D.C.
• Jennifer Lynn Mannie, LADC

• Physical Therapy Assistant in Apple Valley, MN
• Providers in Apple Valley, MN by specialty
• Physical Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.