Individual provider Active NPI

Mason Grimes, PT, DPT

  • Physical Therapist
  • Faribault, MN
National Provider Identifier
1205747623
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14382 Issued in MN
Practice address
35 State Ave Ste 2
Faribault, MN 55021-6369
Phone
(507) 497-3790
NPI assigned
Sep 15, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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 14382 MN Primary

Addresses

Primary practice location

35 State Ave Ste 2
Faribault, MN 55021-6369

Mailing address

36270 County 14 Blvd
Cannon Falls, MN 55009-5238

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1205747623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36270 COUNTY 14 BLVD",
            "city": "CANNON FALLS",
            "state": "MN",
            "postal_code": "550095238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 STATE AVE STE 2",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550216369",
            "telephone_number": "507-497-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "MASON",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-15",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "14382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Faribault, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.