Active NPI
Renee Moyer
- Physical Therapist
- Saint Paul, MN
National Provider Identifier
1700435732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 16261
- Practice address
- 1000 Lovell Ave W
Saint Paul, MN 55113-4459 - Phone
- (651) 484-3378
- NPI assigned
- Sep 11, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 16261 | WI | Primary |
| Physical Therapist | 225100000X | 11666 | MN |
Addresses
Primary practice location
1000 Lovell Ave W
Saint Paul, MN 55113-4459
Mailing address
3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 830-5900
Other practice location 1
800 Riverside Dr
Waupaca, WI 54981-1943
Phone (715) 258-1053
Other names 1
- Renee Johnson
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 |
|---|---|---|---|
| 11666 | MN | MD | Physical Therapist |
| 16261 | WI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thedacare Medical Center - Shawano, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Critical Access Hospital
- Shawano, WI
- NPI 1548260839
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764633600000",
"number": "1700435732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 NEENAH CTR",
"city": "NEENAH",
"state": "WI",
"postal_code": "549563070",
"telephone_number": "920-830-5900",
"fax_number": "920-830-5910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 LOVELL AVE W",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551134459",
"telephone_number": "651-484-3378"
}
],
"practiceLocations": [
{
"address_1": "800 Riverside Dr",
"address_purpose": "LOCATION",
"city": "WAUPACA",
"state": "WI",
"postal_code": "549811943",
"country_code": "US",
"telephone_number": "715-258-1053",
"fax_number": "715-258-1153",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOYER",
"first_name": "RENEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-11",
"last_updated": "2025-12-02",
"certification_date": "2025-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "16261",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "11666",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "RENEE",
"last_name": "JOHNSON",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.