Individual provider Active NPI

Timothy Johnson, DPT

  • Physical Therapist
  • Minneapolis, MN
National Provider Identifier
1124705991
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11747 Issued in MN
Practice address
2021 31St Ave S Apt 2
Minneapolis, MN 55406-4540
Phone
(612) 275-8196
NPI assigned
Jul 3, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11747 MN Primary

Addresses

Primary practice location

2021 31St Ave S Apt 2
Minneapolis, MN 55406-4540

Mailing address

4801 W 81St St Ste 112
Bloomington, MN 55437-1111
Phone (952) 345-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230815004214 MN Practitioner - Physical Therapist in Private Practice 1951763440 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Specialty Services CurrentSince Jan 1, 2025 Accepting new patients
Total Energy Therapy Services LLC Physical Therapist CurrentSince Dec 17, 2025 Accepting new patients
National Dizzy & Balance Center,LTD. Physical Therapist CurrentSince Jul 10, 2023 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2025 Accepting new patients
Fairview Express Care Current Accepting new patients

Locations

1630 101st Ave NE
Ste 160
Blaine, MN 55449
Phone (763) 786-6900

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

4801 W 81st St
Ste 112
Minneapolis, MN 55437
Phone (952) 345-3000

3400 W 66th St
Ste 290
Minneapolis, MN 55435
Phone (952) 836-3637

7650 Currell Blvd
Ste 260
Woodbury, MN 55125
Phone (952) 345-3000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1124705991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 W 81ST ST STE 112",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554371111",
            "telephone_number": "952-345-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 31ST AVE S APT 2",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554064540",
            "telephone_number": "612-275-8196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TIMOTHY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-03",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.