Individual provider Active NPI

Travis Nehowig

  • Physical Therapist
  • Coon Rapids, MN
National Provider Identifier
1285117697
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11062 Issued in MN
Practice address
10160 Foley Blvd NW Ste 120
Coon Rapids, MN 55448-5278
Phone
(763) 585-0700
Fax
(763) 585-0719
NPI assigned
Sep 11, 2018
Sex
Male
Sole proprietor
No

Organizations & group practices 5

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.

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
Park Nicollet Clinic 1,778 clinicians
Tria Orthopaedic Center LLC 504 clinicians

Practice addresses (Care Compare)

15301 Grove Cir N
Maple Grove, MN 55369-4475
Phone (952) 993-5900

15315 Grove Cir N
Maple Grove, MN 55369-4475
Phone (952) 831-8742

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

8100 Northland Dr
Bloomington, MN 55431-4800
Phone (952) 831-8742

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20181105001535 MN Practitioner - Physical Therapist in Private Practice 7810240033 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Jul 1, 2024 Accepting new patients
Park Nicollet Clinic CurrentSince Jul 1, 2024 Accepting new patients
Tria Orthopaedic Center LLC Physical Therapist CurrentSince Jan 1, 2022 Accepting new patients

Locations

15315 Grove Cir N
Maple Grove, MN 55369
Phone (763) 585-0600

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11062 MN Primary

Addresses

NPPES NPI Registry

Primary practice location

10160 Foley Blvd NW Ste 120
Coon Rapids, MN 55448-5278

Mailing address

8170 33Rd Ave S
Ms 21110Q
Bloomington, MN 55425-4516
Phone (763) 585-0700

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 24, 2018.

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1285117697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "763-585-0700",
            "fax_number": "763-585-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10160 FOLEY BLVD NW STE 120",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554485278",
            "telephone_number": "763-585-0700",
            "fax_number": "763-585-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEHOWIG",
        "first_name": "TRAVIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-11",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; 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.