Individual provider Active NPI

Jennifer L. Sorvari-Hedlund, P.T.

  • Physical Therapist
  • Duluth, MN
National Provider Identifier
1215162565
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10973 Issued in MN
Practice address
2701 W Superior St Ste 112
Duluth, MN 55806-1885
Phone
(218) 727-1180
NPI assigned
May 15, 2009
Last updated
Apr 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11235-024 WI
Physical Therapist 225100000X 10973 MN Primary

Addresses

Primary practice location

2701 W Superior St Ste 112
Duluth, MN 55806-1885

Mailing address

2701 W Superior St Ste 112
Duluth, MN 55806-1885
Phone (218) 727-1180

Other practice location 1

4000 N Providence Ave
Appleton, WI 54913-8018
Phone (920) 257-2005

Other identifiers 1

IdentifierTypeStateIssuer
1215162565MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171222000462 MN Practitioner - Physical Therapist in Private Practice 3274687165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapy Partners IncGroup PAC ID 4486552593, 135 clinicians

Practice addresses (Care Compare)

2701 W Superior St
Suite 112
Duluth, MN 55806-1885
Phone (218) 727-1180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11235WIMDDental Hygienist
11235-024WIMDPhysical Therapist
10973MNMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Partners, Inc. Physical Therapist CurrentSince Oct 26, 2017 Accepting new patients
Therapy Partners Inc Physical Therapist CurrentSince Oct 26, 2017 Accepting new patients

Locations

2701 W Superior St
Ste 112
Duluth, MN 55806
Phone (218) 727-1180

4316 Rice Lake Rd
Ste 107
Duluth, MN 55811
Phone (218) 727-1180

1939 Minnehaha Ave W
Ste 300
Saint Paul, MN 55104

1700 Tower Dr W
Stillwater, MN 55082
Phone (651) 275-4706

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1242345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524096000000",
    "number": "1215162565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 W SUPERIOR ST STE 112",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558061885",
            "telephone_number": "218-727-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 W SUPERIOR ST STE 112",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558061885",
            "telephone_number": "218-727-1180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 N PROVIDENCE AVE",
            "address_purpose": "LOCATION",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138018",
            "country_code": "US",
            "telephone_number": "920-257-2005",
            "fax_number": "920-257-2004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SORVARI-HEDLUND",
        "first_name": "JENNIFER",
        "middle_name": "L.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-15",
        "last_updated": "2018-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11235-024",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215162565",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; 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.

Verify at the official NPI Registry.