Individual provider Active NPI

Nolan Weber, DPT

  • Physical Therapist
  • Cottage Grove, MN
National Provider Identifier
1609358803
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11315 Issued in MN
Practice address
6936 Pine Arbor Dr S Ste 150
Cottage Grove, MN 55016-4672
Phone
(651) 459-9686
NPI assigned
Sep 4, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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 11315 MN Primary

Addresses

Primary practice location

6936 Pine Arbor Dr S Ste 150
Cottage Grove, MN 55016-4672

Mailing address

8170 33Rd Ave S
Bloomington, MN 55425-4516
Phone (763) 585-0600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181017002119 MN Practitioner - Physical Therapist in Private Practice 8820340938 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Minnesota Medical School, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novacare Outpatient Rehabilitation East, Inc.Group PAC ID 3678480290, 493 clinicians

Practice addresses (Care Compare)

1387 Phalen Blvd
Saint Paul, MN 55106-2126
Phone (952) 388-5520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11315MNMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Tria Orthopaedic Center LLC Physical Therapist CurrentSince Jan 1, 2022 Accepting new patients
Novacare Outpatient Rehabilitation East Inc Physical Therapist Current Accepting new patients
Novacare Outpatient Rehabilitation East Inc Physical Therapist CurrentSince Mar 26, 2022 Accepting new patients
Novacare Outpatient Rehabilitation East Inc CurrentSince Mar 26, 2022 Accepting new patients
Tria Orthopaedic Center LLC Physical Therapist CurrentSince Jan 1, 2022 Accepting new patients

Locations

480 Osborne Rd NE
Ste 280
Fridley, MN 55432
Phone (763) 784-3155

15315 Grove Cir N
Maple Grove, MN 55369
Phone (763) 585-0600

10091 Dogwood St NW
Minneapolis, MN 55448
Phone (763) 450-0298

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

1387 Phalen Blvd
Saint Paul, MN 55106
Phone (952) 388-5520

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1609358803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "763-585-0600",
            "fax_number": "763-585-0619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6936 PINE ARBOR DR S STE 150",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550164672",
            "telephone_number": "651-459-9686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "NOLAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-04",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottage Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.