Active NPI
Tami Marie Rootkie, LPT
- Physical Therapist
- Mora, MN
National Provider Identifier
1356560213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6325
- Practice address
- 110 7TH St N
Mora, MN 55051-1110 - Phone
- (320) 679-1411
- Fax
- (320) 679-8350
- NPI assigned
- Apr 25, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6325 | MN | Primary |
Addresses
Primary practice location
110 7TH St N
Mora, MN 55051-1110
Mailing address
405 8TH St NW
Pine City, MN 55063-1034
Phone (320) 629-0096
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6325 | MN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356560213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 8TH ST NW",
"city": "PINE CITY",
"state": "MN",
"postal_code": "550631034",
"telephone_number": "320-629-0096",
"fax_number": "320-679-8350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 7TH ST N",
"city": "MORA",
"state": "MN",
"postal_code": "550511110",
"telephone_number": "320-679-1411",
"fax_number": "320-679-8350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROOTKIE",
"first_name": "TAMI",
"middle_name": "MARIE",
"credential": "LPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "6325",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mora, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.