Active NPI
Angela Fedo
- Physical Therapy Assistant
- Duluth, MN
National Provider Identifier
1740666908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A1964
- Practice address
- 2101 Trinity Rd
Duluth, MN 55811 - Phone
- (218) 733-7600
- NPI assigned
- Aug 10, 2015
- Last updated
- Aug 10, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A1964 | MN | Primary |
Addresses
Primary practice location
2101 Trinity Rd
Duluth, MN 55811
Mailing address
2101 Trinity Rd
Duluth, MN 55811-3349
Phone (218) 733-7600
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 |
|---|---|---|---|
| A1964 | MN | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439164800000",
"number": "1740666908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 TRINITY RD",
"city": "DULUTH",
"state": "MN",
"postal_code": "558113349",
"telephone_number": "218-733-7600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 TRINITY RD",
"city": "DULUTH",
"state": "MN",
"postal_code": "55811",
"telephone_number": "218-733-7600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEDO",
"first_name": "ANGELA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-10",
"last_updated": "2015-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MN",
"license": "A1964",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Duluth, MN
- FCSL Lester Park, LLC (Diamond Willow Assisted Living of Lester Park)
- Anna Nell Featherston, PA-C
- Stephanie Fechner, LICSW
- Federal Prison Camp Duluth
- Annette Lynn Fedler, LPN
- Lisa Marie Fedora, M.A., L.P.
- Nicole Feehery-Alpuerto, MS, CNS, LN
- Lisa Marie Feikema
- Kristine Marie Feiro, PHARM.D.
- Ian Christopher Fekete, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.