Active NPI
Michelle King, RPT
- Physical Therapist
- Saint Cloud, MN
National Provider Identifier
1194892323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5416
- Practice address
- 1717 University Dr SE
Saint Cloud, MN 56304-2023 - Phone
- (763) 689-5385
- NPI assigned
- Nov 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5416 | MN | Primary |
Addresses
Primary practice location
1717 University Dr SE
Saint Cloud, MN 56304-2023
Mailing address
116 Edward St S
Pierz, MN 56364-4122
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6411308 | Other | MN | MEDICA |
| HP45892 | Other | MN | HEALTH PARTNERS |
| 11D08TA | Other | MN | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1012 3Rd Ave NE
Little Falls, MN 56345-4647
Phone (320) 434-9641
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5416 | MN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aegis Group Practice LLC | Physical Therapist | Current | Accepting new patients |
| Aegis Group Practice LLC | Physical Therapist | Current | Accepting new patients |
Locations
4933 Old Greenwood Rd
Fort Smith, AR 72903
Organizations & group practices 2
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.
-
- Physical Therapist
- Indian Harbour Beach, FL
- NPI 1932072030
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1194892323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 EDWARD ST S",
"city": "PIERZ",
"state": "MN",
"postal_code": "563644122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 UNIVERSITY DR SE",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563042023",
"telephone_number": "763-689-5385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "MICHELLE",
"credential": "RPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "5416",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "6411308",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP45892",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "11D08TA",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.