Nicole Irene Kenyon, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7436 Issued in MN

Practice address

911 Northland Dr.
Princeton, MN 55371

Phone

(763) 389-6513

Fax

(763) 389-6410

NPI assigned

Oct 17, 2006

Last updated

Sep 5, 2023By 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

Other names 1

• Nicole Irene Mehrwerth Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1154402485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 NORTHLAND DR.",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "55371",
            "telephone_number": "763-389-6513",
            "fax_number": "763-389-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 NORTHLAND DR.",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "55371",
            "telephone_number": "763-389-6513",
            "fax_number": "763-389-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENYON",
        "first_name": "NICOLE",
        "middle_name": "IRENE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "7436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "MEHRWERTH",
            "middle_name": "IRENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Kathryn Marie Knafla, D.C., C.C.S.P
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• Physical Therapist in Princeton, MN
• Providers in Princeton, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.