Active NPI
Lauren Graham
- Physical Therapist
- St Louis Park, MN
National Provider Identifier
1679193049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10832
- Practice address
- 3201 Virginia Ave S
St Louis Park, MN 55426-3624 - Phone
- (952) 935-0333
- NPI assigned
- Apr 25, 2020
- Last updated
- Apr 25, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 10832 | MN | Primary |
Addresses
Primary practice location
3201 Virginia Ave S
St Louis Park, MN 55426-3624
Mailing address
10255 Greenbrier Rd Apt 316
Minnetonka, MN 55305-3427
Phone (218) 280-7720
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lgraham@remedytherapy.net |
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 |
|---|---|---|---|
| 10832 | MN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587772800000",
"number": "1679193049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10255 GREENBRIER RD APT 316",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553053427",
"telephone_number": "218-280-7720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3201 VIRGINIA AVE S",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554263624",
"telephone_number": "952-935-0333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "LAUREN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-25",
"last_updated": "2020-04-25",
"certification_date": "2020-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "10832",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lgraham@remedytherapy.net",
"affiliation": "N",
"endpointDescription": "email",
"address_1": "3201 Virginia Ave S",
"city": "St Louis Park",
"state": "MN",
"country_code": "US",
"postal_code": "554263624",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.