Individual provider Active NPI

Wendy A Rader, P.T.

  • Physical Therapist
  • Edina, MN
National Provider Identifier
1508879255
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5687 Issued in MN
Practice address
3400 W 66TH St
Suite140
Edina, MN 55435-2111
Phone
(952) 345-3000
NPI assigned
Aug 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 5687 MN Primary

Addresses

Primary practice location

3400 W 66TH St
Suite140
Edina, MN 55435-2111

Mailing address

5126 Washburn Ave S
Minneapolis, MN 55410-2252

Other identifiers 1

IdentifierTypeStateIssuer
874617600MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060821000085 MN Practitioner - Physical Therapist in Private Practice 1355344987 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5687MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
National Dizzy & Balance Center,LTD. Physical Therapist CurrentSince Sep 1, 2006 Accepting new patients

Locations

1630 101st Ave NE
Ste 160
Blaine, MN 55449
Phone (763) 786-6900

162 Cobblestone Ln
Burnsville, MN 55337
Phone (952) 345-3000

3400 W 66th St
Ste 140
Edina, MN 55435
Phone (952) 294-4327

4801 W 81st St
Ste 112
Minneapolis, MN 55437
Phone (952) 345-3000

6700 France Ave S
Ste 300
Minneapolis, MN 55435
Phone (952) 345-3000

Interoperability endpoints

  • Direct secure messaging: wrader599962@excellian.direct.allina.com

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508879255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5126 WASHBURN AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554102252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W 66TH ST",
            "address_2": "SUITE140",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352111",
            "telephone_number": "952-345-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADER",
        "first_name": "WENDY",
        "middle_name": "A",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "5687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "874617600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.