Active NPI
Anthony C Yurick, P.T.
- Physical Therapist
- Coon Rapids, MN
National Provider Identifier
1619991502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1511
- Practice address
- 3833 Coon Rapids Blvd NW
Suite 100
Coon Rapids, MN 55433-2697 - Phone
- (763) 427-8320
- Fax
- (763) 712-5429
- NPI assigned
- Jul 26, 2006
- 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 | 1511 | MN | Primary |
Addresses
Primary practice location
3833 Coon Rapids Blvd NW
Suite 100
Coon Rapids, MN 55433-2697
Mailing address
3833 Coon Rapids Blvd NW
Suite 100
Coon Rapids, MN 55433-2697
Phone (763) 427-8320
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 790516 | Other | MN | AMERICA'S PPO |
| 55D53YU | Other | MN | BCBS OF MN |
| 6411546 | Other | MN | MEDICA |
| 962871010735 | Other | MN | PREFERRED ONE |
| HP44365 | Other | MN | HEALTHPARTNERS |
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 |
|---|---|---|---|
| 1511 | MN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323388800000",
"number": "1619991502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3833 COON RAPIDS BLVD NW",
"address_2": "SUITE 100",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554332697",
"telephone_number": "763-427-8320",
"fax_number": "763-712-5429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3833 COON RAPIDS BLVD NW",
"address_2": "SUITE 100",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554332697",
"telephone_number": "763-427-8320",
"fax_number": "763-712-5429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YURICK",
"first_name": "ANTHONY",
"middle_name": "C",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2011-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "1511",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICA'S PPO",
"identifier": "790516",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MN",
"identifier": "55D53YU",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "6411546",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "962871010735",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP44365",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coon Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.