Individual provider Active NPI

Christina Marie Willman, PTA

  • Physical Therapy Assistant
  • Golden Valley, MN
National Provider Identifier
1477860625
Registry record updated Sep 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
7505 Country Club Dr
Golden Valley, MN 55427-4501
Phone
(763) 545-0416
Fax
(763) 545-2016
NPI assigned
Sep 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X Primary

Addresses

Primary practice location

7505 Country Club Dr
Golden Valley, MN 55427-4501

Mailing address

7505 Country Club Dr
Golden Valley, MN 55427-4501
Phone (763) 545-0416

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1477860625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7505 COUNTRY CLUB DR",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274501",
            "telephone_number": "763-545-0416",
            "fax_number": "763-545-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7505 COUNTRY CLUB DR",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274501",
            "telephone_number": "763-545-0416",
            "fax_number": "763-545-2016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLMAN",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-09",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.