Individual provider Active NPI

Joanna Theisen

  • Physical Therapist
  • Edina, MN
National Provider Identifier
1275024903
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11103 Issued in MN
Practice address
4100 Minnesota Dr
Edina, MN 55435-5417
Phone
(952) 456-7000
NPI assigned
May 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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 11103 MN Primary

Addresses

Primary practice location

4100 Minnesota Dr
Edina, MN 55435-5417

Mailing address

3500 American Blvd W Ste 300
Bloomington, MN 55431-4442
Phone (952) 512-5600

Other names 1

  • Joanna Vermedahl Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180723002126 MN Practitioner - Physical Therapist in Private Practice 8224385240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

4010 W 65TH St
Edina, MN 55435-1706
Phone (952) 456-7000

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11103MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA Physical Therapist CurrentSince Jan 25, 2021 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Jan 25, 2021 Accepting new patients

Locations

6520 150th St W
Ste 100
Apple Valley, MN 55124

3365 Central Park Village Dr
#100
Eagan, MN 55121

4100 Minnesota Dr
Edina, MN 55435
Phone (952) 456-7000

3500 American Blvd W
Ste 300
Minneapolis, MN 55431
Phone (952) 512-5600

4010 W 65th St
Minneapolis, MN 55435
Phone (952) 456-7000

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

3912 Excelsior Blvd
St Louis Park, MN 55416
Phone (528) 354-5129

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1275024903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 AMERICAN BLVD W STE 300",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554314442",
            "telephone_number": "952-512-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 MINNESOTA DR",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554355417",
            "telephone_number": "952-456-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEISEN",
        "first_name": "JOANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-29",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOANNA",
            "last_name": "VERMEDAHL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.