Kim Alan Anderson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2787 Issued in MN

Practice address

2801 Wayzata Blvd
Minneapolis, MN 55405-2125

Phone

(612) 707-0169

Fax

(612) 465-1603

NPI assigned

Jan 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13018/brand/1/csg/1/fhir/r4

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.

• MWPT Health and Wellness

  • Physical Therapist
  • New York Mills, MN
  • NPI 1861097552
  NPD Authorized official
• Rehabauthority, LLC

  • Multi-Specialty Clinic/Center
  • Grand Forks, ND
  • NPI 1730159690

  Physical Therapist

  NPD

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1225174683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 WAYZATA BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554052125",
            "telephone_number": "612-707-0169",
            "fax_number": "612-465-1603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 WAYZATA BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554052125",
            "telephone_number": "612-707-0169",
            "fax_number": "612-465-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KIM",
        "middle_name": "ALAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251E1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Ergonomics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "2787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kali B Anderson, L.I.C.S.W.
• Karl Andrew Anderson, OT
• Kathleen Anderson, PT
• Kathleen Gehring Anderson
• Kathryn Brooke Anderson, MD, PHD
• Kyle James Anderson
• Larry L Anderson, PSYD
• Lily Anderson, PT, DPT
• Lilyanna Anderson, LICSW
• Linsey Anderson, RN

• Physical Therapist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; 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.