Active NPI
Colleen Marie Grace, PT
- Physical Therapist
- Minneapolis, MN
National Provider Identifier
1386339760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 12807
- Practice address
- 3915 Golden Valley Rd
Minneapolis, MN 55422-4249 - Phone
- (612) 775-2499
- NPI assigned
- Apr 10, 2023
- 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 | 12807 | MN | Primary |
Addresses
Primary practice location
3915 Golden Valley Rd
Minneapolis, MN 55422-4249
Mailing address
607 Washington Ave N Unit 612
Minneapolis, MN 55401-2468
Phone (330) 636-6921
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 |
|---|---|---|---|
| 12807 | MN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681084800000",
"number": "1386339760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "607 WASHINGTON AVE N UNIT 612",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554012468",
"telephone_number": "330-636-6921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3915 GOLDEN VALLEY RD",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554224249",
"telephone_number": "612-775-2499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRACE",
"first_name": "COLLEEN",
"middle_name": "MARIE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-10",
"last_updated": "2023-04-10",
"certification_date": "2023-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "12807",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.