Active NPI
Megan Martin, PHYSICAL THERAPIST A
- Physical Therapy Assistant
- Duluth, MN
National Provider Identifier
1386089654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A1015
- Practice address
- 2501 Rice Lake Road
Duluth, MN 55811 - Phone
- (218) 625-6400
- NPI assigned
- May 1, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 225200000X | A1015 | MN | Primary |
Addresses
Primary practice location
2501 Rice Lake Road
Duluth, MN 55811
Mailing address
PO Box 274
Esko, MN 55733
Phone (218) 391-0906
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A1015 | Other | MN | PHYSICAL THERAPIST ASSISTANT |
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 |
|---|---|---|---|
| A1015 | MN | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367366400000",
"number": "1386089654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 274",
"city": "ESKO",
"state": "MN",
"postal_code": "55733",
"telephone_number": "218-391-0906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 RICE LAKE ROAD",
"city": "DULUTH",
"state": "MN",
"postal_code": "55811",
"telephone_number": "218-625-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "MEGAN",
"credential": "PHYSICAL THERAPIST A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-01",
"last_updated": "2013-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MN",
"license": "A1015",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPIST ASSISTANT",
"identifier": "A1015",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Duluth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.