Individual provider Active NPI

Rachel A Shimek

  • Physical Therapist
  • Red Wing, MN
National Provider Identifier
1619026291
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6643 Issued in MN
Practice address
701 Hewitt Blvd
Red Wing, MN 55066-2848
Phone
(651) 267-5470
NPI assigned
Jan 10, 2007
Last updated
Sep 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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 6643 MN Primary

Addresses

Primary practice location

701 Hewitt Blvd
Red Wing, MN 55066-2848

Mailing address

17598 Circle Dr
Welch, MN 55089-6327

Other practice location 1

434 Main St
Red Wing, MN 55066-2323
Phone (651) 267-2440

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rshimek80170@ehrdirect.mayoclinicmsg.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040128000817 MN Practitioner - Physical Therapist in Private Practice 1052214095 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6634MNMDChiropractor
6643MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Sep 1, 2019 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Sep 1, 2019 Accepting new patients
Columbia Park Medical Group, PA Past Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

434 Main St
Red Wing, MN 55066
Phone (651) 267-2440

701 Hewitt Blvd
Red Wing, MN 55066
Phone (507) 377-6285

Interoperability endpoints

  • Direct secure messaging: rshimek80170@ehrdirect.mayoclinicmsg.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1619026291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17598 CIRCLE DR",
            "city": "WELCH",
            "state": "MN",
            "postal_code": "550896327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 HEWITT BLVD",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550662848",
            "telephone_number": "651-267-5470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "434 Main St",
            "address_purpose": "LOCATION",
            "city": "Red Wing",
            "state": "MN",
            "postal_code": "550662323",
            "country_code": "US",
            "telephone_number": "651-267-2440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIMEK",
        "first_name": "RACHEL",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "6643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rshimek80170@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "701 Hewitt Blvd",
            "city": "Red Wing",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550662848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Red Wing, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.