Individual provider Active NPI

Talia Jordan Kramer

  • Physical Therapist
  • Dassel, MN
National Provider Identifier
1235620709
Registry record updated May 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11055 Issued in MN
Practice address
621 Parker Ave W
Dassel, MN 55325-1094
Phone
(320) 275-1304
Fax
(320) 275-0161
NPI assigned
May 21, 2018
Last updated
May 21, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2018

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 11055 MN Primary

Addresses

Primary practice location

621 Parker Ave W
Dassel, MN 55325-1094

Mailing address

PO Box 737
Howard Lake, MN 55349-0737
Phone (320) 543-1104

Other practice location 1

1116 6th St
Howard Lake, MN 55349-5676
Phone (320) 543-1104

Other practice location 2

109 5th St NE
Little Falls, MN 56345-2732
Phone (320) 631-1104

Other practice location 3

921 Central Ave E Ste 200
Saint Michael, MN 55376-9618
Phone (763) 497-1153

Other practice location 4

3165 Fernbrook Ln N
Plymouth, MN 55447-5320
Phone (763) 710-4637

Other identifiers 1

IdentifierTypeStateIssuer
1174556682OtherMNNPI

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

LicenseStateTypeSpecialty
11055MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Choice Chiropractic PastSince Jul 20, 2020 Accepting new patients

Organizations & group practices 1

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": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526860800000",
    "number": "1235620709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 737",
            "city": "HOWARD LAKE",
            "state": "MN",
            "postal_code": "553490737",
            "telephone_number": "320-543-1104",
            "fax_number": "321-543-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 PARKER AVE W",
            "city": "DASSEL",
            "state": "MN",
            "postal_code": "553251094",
            "telephone_number": "320-275-1304",
            "fax_number": "320-275-0161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1116 6th St",
            "address_purpose": "LOCATION",
            "city": "Howard Lake",
            "state": "MN",
            "postal_code": "553495676",
            "country_code": "US",
            "telephone_number": "320-543-1104",
            "fax_number": "320-543-1105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 5th St NE",
            "address_purpose": "LOCATION",
            "city": "Little Falls",
            "state": "MN",
            "postal_code": "563452732",
            "country_code": "US",
            "telephone_number": "320-631-1104",
            "fax_number": "320-631-1105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "921 Central Ave E Ste 200",
            "address_purpose": "LOCATION",
            "city": "Saint Michael",
            "state": "MN",
            "postal_code": "553769618",
            "country_code": "US",
            "telephone_number": "763-497-1153",
            "fax_number": "763-497-5256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3165 Fernbrook Ln N",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MN",
            "postal_code": "554475320",
            "country_code": "US",
            "telephone_number": "763-710-4637",
            "fax_number": "763-710-4473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRAMER",
        "first_name": "TALIA",
        "middle_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-21",
        "last_updated": "2018-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1174556682",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dassel, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2018; 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.