Active NPI
Candace K Pella, PT
- Physical Therapist
- Fridley, MN
National Provider Identifier
1518913359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4734
- Practice address
- 500 Osborne Rd NE Ste 365
Fridley, MN 55432-2769 - Phone
- (763) 236-2150
- Fax
- (637) 236-2155
- NPI assigned
- May 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4734 | MN | Primary |
Addresses
Primary practice location
500 Osborne Rd NE Ste 365
Fridley, MN 55432-2769
Mailing address
500 Osborne Rd NE Ste 365
Fridley, MN 55432-2769
Phone (763) 236-2150
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6405366 | Other | MN | MEDICA |
| 134G1PE | Other | MN | BLUE CROSS BLUE SHIELD |
| 713523800 | Medicaid | MN | |
| 125107 | Other | MN | UCARE |
| 936131043346 | Other | MN | PREFERRED ONE |
| HP49410 | Other | MN | HEALTH PARTNERS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4734 | MN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650931200000",
"number": "1518913359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 OSBORNE RD NE STE 365",
"city": "FRIDLEY",
"state": "MN",
"postal_code": "554322769",
"telephone_number": "763-236-2150",
"fax_number": "637-236-2155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 OSBORNE RD NE STE 365",
"city": "FRIDLEY",
"state": "MN",
"postal_code": "554322769",
"telephone_number": "763-236-2150",
"fax_number": "637-236-2155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELLA",
"first_name": "CANDACE",
"middle_name": "K",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-25",
"last_updated": "2022-04-26",
"certification_date": "2022-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "4734",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "6405366",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "134G1PE",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "713523800",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "125107",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "936131043346",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP49410",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fridley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.