Miranda White

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

9751 Regent Ave N
Brooklyn Park, MN 55443-1402

Phone

(763) 315-5340

NPI assigned

Jun 28, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Wisconsin School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ascend Rehab LLCGroup PAC ID 9032351192, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Ascend Rehab, LLC

  • Physical Therapy Clinic/Center
  • St Louis Park, MN
  • NPI 1437403110

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Saint Therese of Oxbow Lake, LLC

  • Skilled Nursing Facility
  • Brooklyn Park, MN
  • NPI 1619236767
  NPD (past)

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

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1639914872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 HIGHWAY 100 S STE 103",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554161599",
            "telephone_number": "763-531-5039",
            "fax_number": "763-531-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9751 REGENT AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431402",
            "telephone_number": "763-315-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "MIRANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harriet Makiti Welwolie
• Emmanuel Randolph Wheagar
• Connie Jo Wheeler, LPCC LADC
• Marcia Wheeler
• Brittany Candace Whitam, BA
• Hilary G Wilde, RD, CDE
• Jessica Wilhelmy, APRN, CNP
• Dante Williams
• Ryan Matthew Williams, MD
• Samdi Vicsu Williams

• Physical Therapist in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.