Individual provider Active NPI

Bethany F. Nienhuis, PT

  • Physical Therapist
  • Golden Valley, MN
National Provider Identifier
1790934180
Registry record updated Sep 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2490 (TEMP) Issued in MN
Practice address
3915 Golden Valley Rd
Courage Center
Golden Valley, MN 55422-4249
Phone
(763) 520-0479
NPI assigned
Sep 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2008

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 2490 (TEMP) MN Primary

Addresses

Primary practice location

3915 Golden Valley Rd
Courage Center
Golden Valley, MN 55422-4249

Mailing address

3915 Golden Valley Rd
Courage Center
Golden Valley, MN 55422-4249
Phone (763) 520-0479

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

LicenseStateTypeSpecialty
2490 (TEMP)MNMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221004800000",
    "number": "1790934180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 GOLDEN VALLEY RD",
            "address_2": "COURAGE CENTER",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224249",
            "telephone_number": "763-520-0479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 GOLDEN VALLEY RD",
            "address_2": "COURAGE CENTER",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224249",
            "telephone_number": "763-520-0479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIENHUIS",
        "first_name": "BETHANY",
        "middle_name": "F.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2008-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "2490 (TEMP)",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.