Mary Ellen Himple, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10852 Issued in MN

Practice address

429 Prairie Center Dr
Eden Prairie, MN 55344-5378

Phone

(952) 828-9500

NPI assigned

Apr 24, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Ellen Bakke Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Colony at Eden Prairie, LLC

  • Skilled Nursing Facility
  • Eden Prairie, MN
  • NPI 1699732420
  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508085002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6647 CANTERBURY LN",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553462842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 PRAIRIE CENTER DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445378",
            "telephone_number": "952-828-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIMPLE",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BAKKE",
            "middle_name": "ELLEN",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kacee Jean Higgins, SLPD, CCC-SLP
• Barry Scott Highbloom, M.D.
• Courtney Jo Hilleshiem
• Richard Hills, P.T., D.C.
• Daniel Himmerick
• Christine Hinkley
• Adrienne Lendsey Hinton Diaz, NP
• Selena Marcanthia Hinton, M.D.
• Christian William Hintz, DPT
• Bryce Henry Hintze, PHARMACIST (B.S.)

• Physical Therapist in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.