Individual provider Active NPI

Tom Juberian, DPT

  • Physical Therapist
  • Baxter, MN
National Provider Identifier
1437582798
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9362 Issued in MN
Practice address
14884 Kirkwood Dr
Baxter, MN 56425-8451
Phone
(218) 824-5027
Fax
(218) 824-8011
NPI assigned
Aug 9, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9362 MN Primary

Addresses

Primary practice location

14884 Kirkwood Dr
Baxter, MN 56425-8451

Mailing address

14884 Kirkwood Dr
Baxter, MN 56425-8451
Phone (218) 824-5027

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
9362MNMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1437582798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14884 KIRKWOOD DR",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258451",
            "telephone_number": "218-824-5027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14884 KIRKWOOD DR",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258451",
            "telephone_number": "218-824-5027",
            "fax_number": "218-824-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUBERIAN",
        "first_name": "TOM",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-09",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "9362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxter, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.

Verify at the official NPI Registry.