Viverantos, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

VIVERANTOS, LLC

Practice address

1769 Lexington Ave N
286
Roseville, MN 55113-6522

Phone

(218) 624-2794

NPI assigned

Apr 6, 2017

Organization subpart

No

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

Authorized official

Name

Michael Ryan Lanham

Title

Director

Phone

(952) 835-4512

Specialties & licenses 1

Addresses

Other names 1

• ViverantOS Doing business as

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491436800000",
    "number": "1346773330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 W CENTRAL ENTRANCE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558115477",
            "telephone_number": "218-624-2794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1769 LEXINGTON AVE N",
            "address_2": "286",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551136522",
            "telephone_number": "218-624-2794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVERANTOS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-06",
        "last_updated": "2017-04-06",
        "status": "A",
        "authorized_official_last_name": "LANHAM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "952-835-4512"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ViverantOS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapist in Roseville, MN
• Providers in Roseville, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.