Active NPI
Stephanie Jo Hatlestad, P.T.
- Physical Therapist
- Edina, MN
National Provider Identifier
1629124540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2837
- Practice address
- 3601 Minnesota Dr
Edina, MN 55435-5281 - Phone
- (952) 851-8200
- NPI assigned
- Jan 25, 2007
- Sex
- Female
- 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 | 2837 | MN | Primary |
Addresses
Primary practice location
3601 Minnesota Dr
Edina, MN 55435-5281
Mailing address
3601 Minnesota Dr
Edina, MN 55435-5281
Phone (952) 851-8200
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 087H8HA | Other | MN | BLUE CROSS INDIVIDUAL ID |
| 1024610 | Other | MN | PREFFERED ONE ID |
| 6B478OR | Other | MN | BLUE CROSS GROUP ID |
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 |
|---|---|---|---|
| 2837 | MN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapy Partners Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Forest Lake, MN
- NPI 1821179607
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406764800000",
"number": "1629124540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3601 MINNESOTA DR",
"city": "EDINA",
"state": "MN",
"postal_code": "554355281",
"telephone_number": "952-851-8200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 MINNESOTA DR",
"city": "EDINA",
"state": "MN",
"postal_code": "554355281",
"telephone_number": "952-851-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HATLESTAD",
"first_name": "STEPHANIE",
"middle_name": "JO",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-25",
"last_updated": "2014-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "2837",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS INDIVIDUAL ID",
"identifier": "087H8HA",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFFERED ONE ID",
"identifier": "1024610",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS GROUP ID",
"identifier": "6B478OR",
"state": "MN"
}
],
"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 Jul 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.