Eric Stanton Niemyer, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

3200 Labore Rd Ste 102
Vadnais Heights, MN 55110-5189

Phone

(952) 835-4512

Fax

(888) 425-0398

NPI assigned

Jun 2, 2021

Sex

Male

Sole proprietor

No

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

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.

• Maverick Physiotherapy LLC

  • Physical Therapist
  • Saint Paul, MN
  • NPI 1073185393
  Medicare reassignment NPD

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1699341354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7825 3RD ST N",
            "address_2": "STE 105",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551285444",
            "telephone_number": "952-835-4512",
            "fax_number": "888-425-0398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 LABORE RD STE 102",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551105189",
            "telephone_number": "952-835-4512",
            "fax_number": "888-425-0398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMYER",
        "first_name": "ERIC",
        "middle_name": "STANTON",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farhia Mursal, PHARM. D
• Megan B Naas, PA-C
• Wendy Haller Nerheim, APRN, CNP
• Christie Marissa Newman, DNP, APRN, FNP-BC
• Justin Robert Nicol, DPT
• Aaron C Nissen, PT, DPT
• Benjamin Todd Nivala, PT, DPT
• Jessica Norman, PHARMD
• Northeast Pediatric Clinic P.a.
• Northern Lights Pediatric & Adolescent Medicine

• Physical Therapist in Vadnais Heights, MN
• Providers in Vadnais Heights, 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 2, 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.