Jeremiah Hales, M.S.,L.P.T.

Primary specialty

SpecialistTaxonomy code 174400000X

License

6782 Issued in MN

Practice address

5107 W 98TH St
Bloomington, MN 55437-2040

Phone

(612) 226-5729

NPI assigned

Feb 28, 2006

Last updated

Oct 1, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

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.

• M-Power Physical Therapy LLC

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  • Bloomington, MN
  • NPI 1780183491
  Authorized official Same address or phone
• Body Balance Golf & Physical Therapy, LLC

  dba Body Balance for Performance

  • Physical Therapist
  • Bloomington, MN
  • NPI 1023014859
  NPD (past)

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285891200000",
    "number": "1457327363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5107 W 98TH ST",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554372040",
            "telephone_number": "612-226-5729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5107 W 98TH ST",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554372040",
            "telephone_number": "612-226-5729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALES",
        "first_name": "JEREMIAH",
        "credential": "M.S.,L.P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2010-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MN",
            "license": "6782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "423915600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "77G34HA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mohamuud Abbas Haji Gelani
• Ifrah Kassim Haji
• Nafiso Haji
• Zackary Hajj-Ali
• Gilbert Aaron Hale
• Derek Michael Hall, MD
• Kristen Rose Halls
• Halo Home Health LLC
• Terrence Keith Halone
• Joyce Halterman

• Specialist in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2010; 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.