Individual provider Active NPI

Kristin Mary Breimhurst Miller, P.T.

  • Physical Therapist
  • Maplewood, MN
National Provider Identifier
1518201201
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4121 Issued in MN
Practice address
1570 Beam Ave
Suite 200
Maplewood, MN 55109-1166
Phone
(651) 232-7820
Fax
(651) 232-7832
NPI assigned
Nov 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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 4121 MN Primary

Addresses

Primary practice location

1570 Beam Ave
Suite 200
Maplewood, MN 55109-1166

Mailing address

1570 Beam Ave
Suite 200
Maplewood, MN 55109-1166
Phone (651) 232-7820

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
4121MNMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353283200000",
    "number": "1518201201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 BEAM AVE",
            "address_2": "SUITE 200",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091166",
            "telephone_number": "651-232-7820",
            "fax_number": "651-232-7832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 BEAM AVE",
            "address_2": "SUITE 200",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091166",
            "telephone_number": "651-232-7820",
            "fax_number": "651-232-7832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREIMHURST MILLER",
        "first_name": "KRISTIN",
        "middle_name": "MARY",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "4121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; 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.