Active NPI
Nicholas William Gmiterko, DPT
- Physical Therapist
- Edina, MN
National Provider Identifier
1558844985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11261
- Practice address
- 3601 Minnesota Dr Ste 600
Edina, MN 55435-5248 - Phone
- (952) 851-8200
- Fax
- (952) 851-8219
- NPI assigned
- Sep 12, 2018
- Sex
- Male
- 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 | 11261 | MN | Primary |
Addresses
Primary practice location
3601 Minnesota Dr Ste 600
Edina, MN 55435-5248
Mailing address
8170 33Rd Ave S
Ms 21110Q
Bloomington, MN 55425-4516
Phone (952) 851-8200
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 |
|---|---|---|---|
| 11261 | MN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537747200000",
"number": "1558844985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8170 33RD AVE S",
"address_2": "MS 21110Q",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554254516",
"telephone_number": "952-851-8200",
"fax_number": "952-851-8219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 MINNESOTA DR STE 600",
"city": "EDINA",
"state": "MN",
"postal_code": "554355248",
"telephone_number": "952-851-8200",
"fax_number": "952-851-8219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GMITERKO",
"first_name": "NICHOLAS",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-12",
"last_updated": "2018-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "11261",
"primary": true
}
],
"identifiers": [],
"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 Sep 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.