NPIMap

Organization Active NPI

Viverant, LLC

  • Physical Therapist
  • Champlin, MN
National Provider Identifier
1659893410
Registry record updated Jul 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
VIVERANT, LLC
Practice address
8900 109TH Ave N Ste 700
Champlin, MN 55316-3150
Phone
(952) 835-4512
NPI assigned
Jul 13, 2017
Last updated
Jul 13, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2017

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

Authorized official

Name
Michael Lanham
Title
Director
Phone
(952) 835-4512

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X
Physical Therapist 225100000X Primary

Addresses

Primary practice location

8900 109TH Ave N Ste 700
Champlin, MN 55316-3150

Mailing address

1769 Lexington Ave N # 286
Roseville, MN 55113-6522
Phone (952) 835-4512

National Provider Directory

National Provider Directory
Tax ID family
Viverant LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499904000000",
    "number": "1659893410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1769 LEXINGTON AVE N # 286",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551136522",
            "telephone_number": "952-835-4512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 109TH AVE N STE 700",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553163150",
            "telephone_number": "952-835-4512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVERANT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-13",
        "last_updated": "2017-07-13",
        "status": "A",
        "authorized_official_last_name": "LANHAM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "952-835-4512"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champlin, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.