Active NPI
Pamela Jean Blendermann, PT
- Physical Therapist
- Shorewood, MN
National Provider Identifier
1205122017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 8729
- Practice address
- 23490 Highway 7
Shorewood, MN 55331-3141 - Phone
- (612) 888-9882
- Fax
- (612) 888-9886
- NPI assigned
- Jun 21, 2011
- 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 | 8729 | MN | Primary |
Addresses
Primary practice location
23490 Highway 7
Shorewood, MN 55331-3141
Mailing address
1939 Minnehaha Ave W Ste 300
Saint Paul, MN 55104-1033
Phone (651) 748-4338
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8729 | MN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665532800000",
"number": "1205122017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1939 MINNEHAHA AVE W STE 300",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551041033",
"telephone_number": "651-748-4338",
"fax_number": "651-748-2892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23490 HIGHWAY 7",
"city": "SHOREWOOD",
"state": "MN",
"postal_code": "553313141",
"telephone_number": "612-888-9882",
"fax_number": "612-888-9886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLENDERMANN",
"first_name": "PAMELA",
"middle_name": "JEAN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-21",
"last_updated": "2022-10-12",
"certification_date": "2022-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "8729",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shorewood, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.