Active NPI
Kathryn Lee Meryhew, DPT
- Physical Therapist
- Coon Rapids, MN
National Provider Identifier
1811488711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10855
- Practice address
- 3111 124TH Ave NW Ste 123
Coon Rapids, MN 55433-4573 - Phone
- (763) 236-7337
- NPI assigned
- May 25, 2018
- Sex
- Female
- Sole proprietor
- No
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 Therapist | 225100000X | 10855 | MN | Primary |
Addresses
Primary practice location
3111 124TH Ave NW Ste 123
Coon Rapids, MN 55433-4573
Mailing address
1080 Sperl St
Saint Paul, MN 55118-1658
Phone (651) 769-5150
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ETB126679257001 | Other | MN | BLUE CROSS BLUE SHIELD |
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 |
|---|---|---|---|
| 10855 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allina Health System | Past | 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 and National Provider Directory roles.
-
dba Allina Health TeleRheumatology
- Rheumatology Physician
- Coon Rapids, MN
- NPI 1952146516
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1811488711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1080 SPERL ST",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551181658",
"telephone_number": "651-769-5150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3111 124TH AVE NW STE 123",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554334573",
"telephone_number": "763-236-7337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERYHEW",
"first_name": "KATHRYN",
"middle_name": "LEE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-25",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "10855",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "ETB126679257001",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coon Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.