Active NPI
Ryan Raymond Rolfes
- Physical Therapy Assistant
- St Cloud, MN
National Provider Identifier
1609632363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A2206
- Practice address
- 2835 W. St. Germain St.
#300
St Cloud, MN 56301-7729 - Phone
- (320) 259-4151
- Fax
- (320) 259-5707
- NPI assigned
- Feb 21, 2024
- 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 Therapy Assistant | 225200000X | A2206 | MN | Primary |
Addresses
Primary practice location
2835 W. St. Germain St.
#300
St Cloud, MN 56301-7729
Mailing address
2835 W. St. Germain St.
#300
St Cloud, MN 56301-7729
Phone (320) 259-4151
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A2206 | MN | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708473600000",
"number": "1609632363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2835 W. ST. GERMAIN ST.",
"address_2": "#300",
"city": "ST CLOUD",
"state": "MN",
"postal_code": "563017729",
"telephone_number": "320-259-4151",
"fax_number": "320-259-5707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2835 W. ST. GERMAIN ST.",
"address_2": "#300",
"city": "ST CLOUD",
"state": "MN",
"postal_code": "563017729",
"telephone_number": "320-259-4151",
"fax_number": "320-259-5707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROLFES",
"first_name": "RYAN",
"middle_name": "RAYMOND",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-02-21",
"last_updated": "2024-02-21",
"certification_date": "2024-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MN",
"license": "A2206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.