Loon State Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

LOON STATE PHYSICAL THERAPY

Practice address

4420 Drew Ave S
Minneapolis, MN 55410-1337

Phone

(612) 405-8503

NPI assigned

Jan 12, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Andrew Eccles, DPTNPI 1457888638

Title

Owner

Phone

(612) 805-2676

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrew Eccles

  • Physical Therapist
  • Inver Grove Heights, MN
  • NPI 1457888638
  NPD Authorized official
• Jessica Czarnecki, DPT

  • Physical Therapist
  • Highlands Ranch, CO
  • NPI 1295352136
  NPD (past)

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610409600000",
    "number": "1194314401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 12TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554173239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 DREW AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554101337",
            "telephone_number": "612-405-8503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 N 2nd St Ste 108",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554112243",
            "country_code": "US",
            "telephone_number": "612-405-8503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LOON STATE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-12",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A",
        "authorized_official_last_name": "ECCLES",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-805-2676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Marie Looby, DO, MS
• Wendy Sue Looman, PHD, RN, CPNP
• Ashley Renee Loomis, MD
• Troy D Loomis, OD
• Loon Lake EMS, LLC
• Loop Dental PLLC
• Brianna Marie Loop, MSW
• Krista J Loop, CFNP
• Michele Montejo Loor, MD
• Thomas Stewart Loper, D.D.S.

• Physical Therapy Clinic/Center in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Physical Therapy Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.