Individual provider Active NPI

Kimberly M Myers

  • Physical Therapist
  • St Louis Park, MN
National Provider Identifier
1801020458
Registry record updated May 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2514 Issued in MN
Practice address
6500 Excelsior Blvd
St Louis Park, MN 55426
Phone
(952) 993-5900
NPI assigned
May 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2009

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 2514 MN Primary

Addresses

Primary practice location

6500 Excelsior Blvd
St Louis Park, MN 55426

Mailing address

6465 Wayzata Blvd
Suite 210
St Louis Park, MN 55426

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090715000570 MN Practitioner - Physical Therapist in Private Practice 7517019987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optage IncGroup PAC ID 2264619345, 61 clinicians

Practice addresses (Care Compare)

1925 Norfolk Ave
Saint Paul, MN 55116-2575
Phone (651) 631-6570

2945 Lincoln Dr
Roseville, MN 55113-1338
Phone (651) 631-6570

6000 Chaska Rd
Shorewood, MN 55331-3173
Phone (651) 631-6570

6307 Burnham Cir
Inver Grove Heights, MN 55076-1666
Phone (651) 631-6570

6600 Auto Club Rd
Bloomington, MN 55438-2425
Phone (615) 631-6570

7601 Lyndale Ave S
Richfield, MN 55423-4073
Phone (651) 631-6570

825 Mount Curve Blvd
Saint Paul, MN 55116-3035
Phone (651) 631-6570

8725 Promenade LN
Woodbury, MN 55125-9622
Phone (651) 631-6570

900 Old Lexington Ave
Saint Paul, MN 55116-2845
Phone (615) 631-6570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2514MNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Optage Inc Physical Therapist CurrentSince Mar 20, 2023 Accepting new patients
Optage Inc Physical Therapist CurrentSince Mar 20, 2023 Accepting new patients

Locations

2845 Hamline Ave N
Saint Paul, MN 55113
Phone (651) 631-6100

Organizations & group practices 2

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": "1242086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242086400000",
    "number": "1801020458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 WAYZATA BLVD",
            "address_2": "SUITE 210",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "55426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 EXCELSIOR BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "55426",
            "telephone_number": "952-993-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-12",
        "last_updated": "2009-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "2514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; 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.