Individual provider Active NPI

Carlie Jo Steffenson

  • Physical Therapy Assistant
  • Evansville, MN
National Provider Identifier
1245918556
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
17714 W Ina Rd NW
Evansville, MN 56326-4534
Phone
(320) 808-8707
NPI assigned
Jul 6, 2023
Last updated
Jul 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X Primary

Addresses

Primary practice location

17714 W Ina Rd NW
Evansville, MN 56326-4534

Mailing address

17714 W Ina Rd NW
Evansville, MN 56326-4534
Phone (320) 808-8707

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1245918556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17714 W INA RD NW",
            "city": "EVANSVILLE",
            "state": "MN",
            "postal_code": "563264534",
            "telephone_number": "320-808-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17714 W INA RD NW",
            "city": "EVANSVILLE",
            "state": "MN",
            "postal_code": "563264534",
            "telephone_number": "320-808-8707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFFENSON",
        "first_name": "CARLIE",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-06",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; 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.