Individual provider Active NPI

Alice Ann Vawter, PHYSICAL THERAPIST

  • Physical Therapist
  • Minneapolis, MN
National Provider Identifier
1467793711
Registry record updated Mar 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8415 Issued in MN
Practice address
800 East 28TH Street
Abbott Northwestern Hospital Sister Kenny Pavilion
Minneapolis, MN 55407
Phone
(612) 863-4457
NPI assigned
Mar 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 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 8415 MN Primary

Addresses

Primary practice location

800 East 28TH Street
Abbott Northwestern Hospital Sister Kenny Pavilion
Minneapolis, MN 55407

Mailing address

5017 14TH Ave S
Minneapolis, MN 55417-1124
Phone (262) 490-4961

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260417000933 MN Practitioner - Physical Therapist in Private Practice 0446726392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3804 Huntingdon Dr
Hopkins, MN 55305-5115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363046400000",
    "number": "1467793711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5017 14TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554171124",
            "telephone_number": "262-490-4961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 EAST 28TH STREET",
            "address_2": "ABBOTT NORTHWESTERN HOSPITAL SISTER KENNY PAVILION",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55407",
            "telephone_number": "612-863-4457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAWTER",
        "first_name": "ALICE",
        "middle_name": "ANN",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-12",
        "last_updated": "2013-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "8415",
            "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 Mar 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.