Viverant PT LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

VIVERANT PT LLC

Practice address

3912 Excelsior Blvd
St.Louis Park, MN 55416-0515

Phone

(952) 835-4512

Fax

(952) 515-5655

NPI assigned

May 19, 2020

Organization subpart

No

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

Authorized official

Name

Dennis Cernohous

Title

Ceo/Partner

Phone

(952) 835-4512

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lauren McCaughtry, OTR/L

  • Occupational Therapist
  • Maple Grove, MN
  • NPI 1700740644
  NPD

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589846400000",
    "number": "1396368866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7825 3RD ST N",
            "address_2": "STE 105",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551285444",
            "telephone_number": "952-835-4512",
            "fax_number": "952-516-5655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3912 EXCELSIOR BLVD",
            "city": "ST.LOUIS PARK",
            "state": "MN",
            "postal_code": "554160515",
            "telephone_number": "952-835-4512",
            "fax_number": "952-515-5655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVERANT PT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-19",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A",
        "authorized_official_last_name": "CERNOHOUS",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "CEO/PARTNER",
        "authorized_official_telephone_number": "952-835-4512"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Muna Yasin Abdullahi
• Samatar Hussein Bule
• Caitlin Kwiatkowski
• Dahira Salah Mohamed
• Ahmed Abdi Woli

• Physical Therapist in St.Louis Park, MN
• Providers in St.Louis Park, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; 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.