Synergy Physical Therapy, Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

3080 Issued in MN

Legal business name

SYNERGY PHYSICAL THERAPY, INC

Practice address

10657 165TH St W
Lakeville, MN 55044-5670

Phone

(952) 435-0343

Fax

(952) 435-0344

NPI assigned

Feb 12, 2010

Last updated

May 28, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paul Allen Holmquist, BSPTNPI 1619067931

Title

President

Phone

(952) 435-0343

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Paul Allen Holmquist, PHYSICAL THERAPIST

  • Physical Therapist
  • Burnsville, MN
  • NPI 1619067931
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1265932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622160000000",
    "number": "1649502881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10657 165TH ST W",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550445670",
            "telephone_number": "952-435-0343",
            "fax_number": "952-435-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10657 165TH ST W",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550445670",
            "telephone_number": "952-435-0343",
            "fax_number": "952-435-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-12",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A",
        "authorized_official_last_name": "HOLMQUIST",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-435-0343",
        "authorized_official_credential": "BSPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MN",
            "license": "3080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "955230800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy L Swanson, PHARM.D.
• Malakai Swanson
• Julia Swedberg, MA, LPC
• Hannah Swenson
• Alexis McKenzie Sylvester
• Titi Taiwo
• Target Bunwal Healthcare
• Hamdi Tebad
• Valeriy Telkov, DC
• Jamie Terning, MASSAGE THERAPIST

• Physical Therapy Clinic/Center in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Physical Therapy Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.