Jeanna Dwyer, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8828 Issued in MN

Practice address

6625 Lyndale Ave S Ste 430
Richfield, MN 55423-2300

Phone

(952) 285-2840

NPI assigned

Jul 12, 2011

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

Other names 1

• Jeanna Shirley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Capernaum Pediatric Therapy, Inc.

  • Specialist
  • Richfield, MN
  • NPI 1619978228
  NPD
• Hands Hooves and Hearts Therapeutic Services LLC

  • Pediatric Occupational Therapist
  • Ramsey, MN
  • NPI 1891332599

  Physical Therapist

  NPD

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1114215183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 LYNDALE AVE S STE 430",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232300",
            "telephone_number": "952-285-2840"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWYER",
        "first_name": "JEANNA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-12",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "8828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANNA",
            "last_name": "SHIRLEY",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karlu Dorleh, NP
• Downtown Eyes Crosstown PLLC
• Dragonfly Children'S Respite Home Inc.
• Nanci Duarte Ponce
• Jeannie Dubray
• Dennis Ea, MD
• Ease Comfort LLC
• Juan-Ita Effiom, OTR
• Egan Chiropractic and Acupuncture LTD
• Tiffany Egan, D.C.

• Physical Therapist in Richfield, MN
• Providers in Richfield, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.