Active NPI
Stacy C Mosiman, PT
- Physical Therapist
- Hopkins, MN
National Provider Identifier
1538459912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6076
- Practice address
- 700 South 5TH Street
Hopkins, MN 55343 - Phone
- (952) 993-6087
- Fax
- (952) 993-5081
- NPI assigned
- Apr 19, 2011
- 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 | 6076 | MN | Primary |
Addresses
Primary practice location
700 South 5TH Street
Hopkins, MN 55343
Mailing address
700 South 5TH Street
Hopkins, MN 55343
Phone (952) 993-6087
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 |
|---|---|---|---|
| 6076 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Soderberg Physical Therapy LLC | Past | Accepting new patients |
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.
-
- Orthopedic Physical Therapist
- Golden Valley, MN
- NPI 1144236688
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303171200000",
"number": "1538459912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 SOUTH 5TH STREET",
"city": "HOPKINS",
"state": "MN",
"postal_code": "55343",
"telephone_number": "952-993-6087",
"fax_number": "952-993-5081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 SOUTH 5TH STREET",
"city": "HOPKINS",
"state": "MN",
"postal_code": "55343",
"telephone_number": "952-993-6087",
"fax_number": "952-993-5081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSIMAN",
"first_name": "STACY",
"middle_name": "C",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-19",
"last_updated": "2011-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "6076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hopkins, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.