NPIMap

Organization Active NPI

Northern Star Therapy LTD

  • Physical Therapist
  • Sartell, MN
National Provider Identifier
1275856304
Registry record updated Mar 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
NORTHERN STAR THERAPY LTD
Practice address
2395 Troop Dr
Suite 102
Sartell, MN 56377-4694
Phone
(320) 258-3022
Fax
(320) 258-0389
NPI assigned
Mar 3, 2010
Last updated
Mar 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2010

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

Authorized official

Name
Dan Weaver
Title
Ceo
Phone
(320) 240-6955

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

2395 Troop Dr
Suite 102
Sartell, MN 56377-4694

Mailing address

251 County Road 120
Suite a
Saint Cloud, MN 56303-4872
Phone (320) 259-5429

Other identifiers 3

IdentifierTypeStateIssuer
264M1NOOtherMNBLUE CROSS BLUE SHIELD OF MN
6B481NOOtherMNBLUE CROSS BLUE SHIELD OF MN
4G183NOOtherMNBLUE CROSS BLUE SHIELD OF MN

National Provider Directory

National Provider Directory

Locations

2395 Troop Dr
Unit 102
Sartell, MN 56377
Phone (320) 252-0233

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1267574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269907200000",
    "number": "1275856304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 COUNTY ROAD 120",
            "address_2": "SUITE A",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034872",
            "telephone_number": "320-259-5429",
            "fax_number": "320-240-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2395 TROOP DR",
            "address_2": "SUITE 102",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774694",
            "telephone_number": "320-258-3022",
            "fax_number": "320-258-0389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN STAR THERAPY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-03",
        "last_updated": "2010-03-30",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "320-240-6955"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MN",
            "identifier": "264M1NO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MN",
            "identifier": "6B481NO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MN",
            "identifier": "4G183NO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sartell, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2010; 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.