Individual provider Active NPI

John E Amundson, DPT

  • Orthopedic Physical Therapist
  • Alexandria, MN
National Provider Identifier
1124431481
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
9594 Issued in MN
Practice address
410 30TH Ave E Ste 102
Alexandria, MN 56308-4770
Phone
(320) 763-5505
Fax
(320) 763-4447
NPI assigned
Jun 4, 2014
Sex
Male
Sole proprietor
No

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

LicenseStateTypeSpecialty
9594MNMDFamily Nurse Practitioner

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 9594 MN Primary

Addresses

NPPES NPI Registry

Primary practice location

410 30TH Ave E Ste 102
Alexandria, MN 56308-4770

Mailing address

410 30TH Ave E Ste 102
Alexandria, MN 56308-4770
Phone (320) 763-5505

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
41-2017731OtherMNGROUP NPI # 1184700924

Other names 1

NPPES NPI Registry
  • John E Amundson Professional name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 4, 2014.

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1124431481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 30TH AVE E STE 102",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563084770",
            "telephone_number": "320-763-5505",
            "fax_number": "320-763-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 30TH AVE E STE 102",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563084770",
            "telephone_number": "320-763-5505",
            "fax_number": "320-763-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMUNDSON",
        "first_name": "JOHN",
        "middle_name": "E",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-04",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MN",
            "license": "9594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI # 1184700924",
            "identifier": "41-2017731",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "AMUNDSON",
            "middle_name": "E",
            "credential": "DPT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Alexandria, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; 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.