Individual provider Active NPI

Chanda D Jothen, DPT

  • Orthopedic Physical Therapist
  • Eagan, MN
National Provider Identifier
1336394634
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
8085 Issued in MN
Practice address
2640 Eagan Woods Dr Ste 120
Eagan, MN 55121-1466
Phone
(651) 968-5600
Fax
(651) 730-3998
NPI assigned
Dec 1, 2008
Last updated
Oct 20, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 8085 MN Primary

Addresses

Primary practice location

2640 Eagan Woods Dr Ste 120
Eagan, MN 55121-1466

Mailing address

PO Box 86 SDS 12 2901
Minneapolis, MN 55486-2901
Phone (651) 968-5050

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
8085MNMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287532800000",
    "number": "1336394634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86 SDS 12 2901",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554862901",
            "telephone_number": "651-968-5050",
            "fax_number": "651-968-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 EAGAN WOODS DR STE 120",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211466",
            "telephone_number": "651-968-5600",
            "fax_number": "651-730-3998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOTHEN",
        "first_name": "CHANDA",
        "middle_name": "D",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-01",
        "last_updated": "2010-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MN",
            "license": "8085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.