Individual provider Active NPI

Jonathan F. Reynolds, PHYSICAL THERAPIST

  • Physical Therapist
  • Eagan, MN
National Provider Identifier
1720168362
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6944 Issued in MN
Practice address
2119 Cliff Rd
Eagan, MN 55122-2345
Phone
(651) 688-7500
Fax
(763) 260-7653
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6944 MN Primary

Addresses

Primary practice location

2119 Cliff Rd
Eagan, MN 55122-2345

Mailing address

1939 Minnehaha Ave W Ste 300
Saint Paul, MN 55104-1033
Phone (651) 748-4338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070716000312 MN Practitioner - Physical Therapist in Private Practice 2860592102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapy Partners IncGroup PAC ID 4486552593, 135 clinicians

Practice addresses (Care Compare)

2119 Cliff Rd
Eagan, MN 55122-2345
Phone (651) 688-7500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Partners, Inc. Physical Therapist CurrentSince Jan 2, 2025 Accepting new patients
Therapy Partners Inc Physical Therapist CurrentSince Jan 2, 2025 Accepting new patients
Waypoint Minnesota PC PastSince Nov 10, 2019 Accepting new patients

Locations

11995 Singletree Ln
Ste 120
Eden Prairie, MN 55344
Phone (952) 373-5720

9325 Upland Ln N
Ste 230
Maple Grove, MN 55369
Phone (763) 242-3436

43 SE Main St
Ste 223
Minneapolis, MN 55414
Phone (612) 331-5757

1939 Minnehaha Ave W
Ste 300
Saint Paul, MN 55104

2119 Cliff Rd
Saint Paul, MN 55122
Phone (612) 251-8173

1700 Tower Dr W
Stillwater, MN 55082
Phone (651) 275-4706

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1720168362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 MINNEHAHA AVE W STE 300",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041033",
            "telephone_number": "651-748-4338",
            "fax_number": "651-748-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 CLIFF RD",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222345",
            "telephone_number": "651-688-7500",
            "fax_number": "763-260-7653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JONATHAN",
        "middle_name": "F.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "6944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.