Individual provider Active NPI

Joshua Campbell Dames

  • Physical Therapy Clinic/Center
  • Coon Rapids, MN
National Provider Identifier
1396511770
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
13358 Issued in MN
Practice address
2104 Northdale Blvd NW Ste 100
Coon Rapids, MN 55433-3045
Phone
(763) 755-5495
NPI assigned
Nov 28, 2023
Last updated
Nov 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 13358 MN Primary

Addresses

Primary practice location

2104 Northdale Blvd NW Ste 100
Coon Rapids, MN 55433-3045

Mailing address

2104 Northdale Blvd NW Ste 100
Coon Rapids, MN 55433-3045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240930002850 MN Practitioner - Physical Therapist in Private Practice 8022549195 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13358MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novacare Outpatient Rehabilitation East Inc Physical Therapy CurrentSince Aug 18, 2024 Accepting new patients
Novacare Outpatient Rehabilitation East Inc Physical Therapy Current Accepting new patients
Novacare Outpatient Rehabilitation East, Inc. Physical Therapy CurrentSince Aug 18, 2024 Accepting new patients

Locations

10091 Dogwood St NW
Minneapolis, MN 55448
Phone (763) 450-0298

2104 Northdale Blvd NW
Ste 100
Minneapolis, MN 55433
Phone (763) 755-5495

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1396511770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 NORTHDALE BLVD NW STE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554333045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 NORTHDALE BLVD NW STE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554333045",
            "telephone_number": "763-755-5495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMES",
        "first_name": "JOSHUA",
        "middle_name": "CAMPBELL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-28",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MN",
            "license": "13358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.