Supreme Physical Therapy, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4097 Issued in MN

Legal business name

SUPREME PHYSICAL THERAPY, INC.

Practice address

5201 Chowen Ave S
Minneapolis, MN 55410-2121

Phone

(612) 805-2741

NPI assigned

Feb 6, 2006

Organization subpart

No

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

Authorized official

Name

Susan Mary Priem, PHYSICAL THERAPISTNPI 1144205840

Title

Owner

Phone

(612) 805-2741

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Mary Priem, P.T.

  • Physical Therapist
  • Minneapolis, MN
  • NPI 1144205840
  NPD (past) Authorized official

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255303095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 CHOWEN AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554102121",
            "telephone_number": "612-805-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 CHOWEN AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554102121",
            "telephone_number": "612-805-2741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRIEM",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-805-2741",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "4097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "349G0SU",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Supportive Housing and Managed Care Pilot
• Supportive Housing and Managed Care Pilot
• Supportive Housing and Managed Care Pilot
• Supportive Housing Services
• Supreme Care, Inc.
• Surad Interpreting and Translation
• Vishnu Laalitha Surapaneni, MD
• Mithun Raghu Suresh, M.D.
• Surgical Specialists of Minnesota
• Muhammad A. K. Suri, M.D.

• 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 Aug 22, 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.