Individual provider Active NPI

Miranda Biegon Swensen, DPT

  • Physical Therapist
  • Maplewood, MN
National Provider Identifier
1518636158
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
49866702401 Issued in UT
Practice address
2495 Maplewood Dr N Ste 313
Maplewood, MN 55109-1985
Phone
(651) 770-8884
NPI assigned
Sep 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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 49866702401 UT Primary

Addresses

Primary practice location

2495 Maplewood Dr N Ste 313
Maplewood, MN 55109-1985

Mailing address

3148 29TH Ave S
Minneapolis, MN 55406-1922
Phone (801) 759-1478

Other names 1

  • Miranda Biegon Former name

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
49866702401UTMDPhysical Therapist
12481MNMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1518636158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3148 29TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554061922",
            "telephone_number": "801-759-1478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 MAPLEWOOD DR N STE 313",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091985",
            "telephone_number": "651-770-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWENSEN",
        "first_name": "MIRANDA",
        "middle_name": "BIEGON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-08",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "49866702401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRANDA",
            "last_name": "BIEGON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Sep 8, 2021; 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.