Active NPI
Scott Degraff
- Physical Therapist
- Bloomington, MN
National Provider Identifier
1629441902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7376
- Practice address
- 9200 Nicollet Ave S
Bloomington, MN 55420-3714 - Phone
- (952) 881-8676
- NPI assigned
- Nov 9, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 | 7376 | MN | Primary |
Addresses
Primary practice location
9200 Nicollet Ave S
Bloomington, MN 55420-3714
Mailing address
17816 Fieldfare Way
Lakeville, MN 55044-3820
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 |
|---|---|---|---|
| 7376 | MN | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447027200000",
"number": "1629441902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17816 FIELDFARE WAY",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "550443820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9200 NICOLLET AVE S",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554203714",
"telephone_number": "952-881-8676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEGRAFF",
"first_name": "SCOTT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-11-09",
"last_updated": "2015-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "7376",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.