Active NPI
Martin J Janowak, LMT, CST, BCTMB
- Mechanotherapist
- Plymouth, MN
National Provider Identifier
1255784591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- License
- MT3400695
- Practice address
- 6125 Ives LN N
Plymouth, MN 55442-1248 - Phone
- (612) 222-6221
- NPI assigned
- Jul 21, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | MT3400695 | MN | Primary |
Addresses
Primary practice location
6125 Ives LN N
Plymouth, MN 55442-1248
Mailing address
6125 Ives LN N
Plymouth, MN 55442-1248
Phone (612) 222-6221
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT3400695 | MN | MD | Mechanotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469059200000",
"number": "1255784591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6125 IVES LN N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554421248",
"telephone_number": "612-222-6221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6125 IVES LN N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554421248",
"telephone_number": "612-222-6221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANOWAK",
"first_name": "MARTIN",
"middle_name": "J",
"credential": "LMT, CST, BCTMB",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-07-21",
"last_updated": "2016-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "MN",
"license": "MT3400695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.