Justin Kyle Blood – Orthopedic Physical Therapist

Key facts

NPI: 1295863934
Entity type: Individual (NPI type 1)
Primary specialty: Orthopedic Physical Therapist 2251X0800X
License: 6905 (MN)
Practice address: 4180 Lexington Ave N
Shoreview, MN 55126-6106
Phone: (651) 241-1455
Fax: (651) 241-1456
NPI assigned: Mar 2, 2007
Sex: Male
Sole proprietor: No

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.

Therapy Partners, Inc. Multi-Specialty Clinic/Center · Saint Paul, MN · NPI 1407809494

NPD
Integrated Chiropractic Services Chiropractor · White Bear Lake, MN · NPI 1538468293

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
6905	MN	MD	Chiropractor

Practice roles

Organization	Specialty	Status	New patients
Therapy Partners, Inc.		Current since Jun 3, 2019	Accepting new patients
Integrated Chiropractic Services		Past	Accepting new patients

Locations

11995 Singletree Ln
Ste 120
Eden Prairie, MN 55344
Phone (952) 373-5720

9325 Upland Ln N
Ste 230
Maple Grove, MN 55369
Phone (763) 242-3436

2125 E Hennepin Ave
Ste 300
Minneapolis, MN 55413
Phone (612) 750-7168

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Orthopedic Physical Therapist	2251X0800X	6905	MN	Yes

Addresses

Primary practice location

4180 Lexington Ave N
Shoreview, MN 55126-6106

Mailing address

1739 Hillview Rd
Shoreview, MN 55126-4909
Phone (651) 241-1455

Other providers in Shoreview, MN

All providers in Shoreview, MN · Orthopedic Physical Therapist in Minnesota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.