Individual provider Active NPI

Sheila Mahigan Grove, PTA

  • Physical Therapy Assistant
  • Woodbury, MN
National Provider Identifier
1811164064
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A558 Issued in MN
Practice address
1625 Radio Dr
Suite 220
Woodbury, MN 55125-9407
Phone
(651) 241-3636
Fax
(651) 241-3646
NPI assigned
May 15, 2008
Last updated
Apr 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A558 MN Primary

Addresses

Primary practice location

1625 Radio Dr
Suite 220
Woodbury, MN 55125-9407

Mailing address

1625 Radio Dr Ste 220
Woodbury, MN 55125-9476
Phone (651) 241-3636

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
A558MNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System PastSince Apr 5, 2020 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1811164064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 RADIO DR STE 220",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551259476",
            "telephone_number": "651-241-3636",
            "fax_number": "651-241-3646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 RADIO DR",
            "address_2": "SUITE 220",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551259407",
            "telephone_number": "651-241-3636",
            "fax_number": "651-241-3646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVE",
        "first_name": "SHEILA",
        "middle_name": "MAHIGAN",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-15",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MN",
            "license": "A558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; 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.