Renee Jean Persson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

625 Issued in MN

Practice address

8425 Seasons Pkwy
Suite 103
Woodbury, MN 55125-4392

Phone

(651) 254-8545

NPI assigned

Dec 30, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1230595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230595200000",
    "number": "1669618344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8425 SEASONS PKWY",
            "address_2": "SUITE 103",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254392",
            "telephone_number": "651-254-8545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8425 SEASONS PKWY",
            "address_2": "SUITE 103",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254392",
            "telephone_number": "651-254-8545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSSON",
        "first_name": "RENEE",
        "middle_name": "JEAN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-30",
        "last_updated": "2008-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MN",
            "license": "625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMPI",
            "identifier": "A176977400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keisha Perrenoud, RN
• David Valentine Perrin, LICSW
• Cheryl Jean Perron-Kaufer, CNS
• Missy Young Perry, MA, LMFT
• Sarah Kathleen Perryman, A.T.C.
• Mary Perzel, PT
• Sally Nicole Peters, DDS, MS
• Kristy Lynn Petersen, DDS
• Lars Petersen, PT, DPT
• Rebecca J Petersen, DDS

• Physical Therapy Assistant in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Physical Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2008; 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.