Active NPI
Jan Mary Dahl, MA PT
- Physical Therapist
- Minneapolis, MN
National Provider Identifier
1851405658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5522
- Practice address
- 1800 2ND Street NE
A Chance to Grow
Minneapolis, MN 55418 - Phone
- (612) 706-5537
- Fax
- (612) 706-5555
- NPI assigned
- Aug 18, 2006
- 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 | 5522 | MN | Primary |
Addresses
Primary practice location
1800 2ND Street NE
A Chance to Grow
Minneapolis, MN 55418
Mailing address
11071 Dogwood St NW
Coon Rapids, MN 55448
Phone (763) 754-6760
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5522 | MN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1851405658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11071 DOGWOOD ST NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "55448",
"telephone_number": "763-754-6760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 2ND STREET NE",
"address_2": "A CHANCE TO GROW",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55418",
"telephone_number": "612-706-5537",
"fax_number": "612-706-5555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAHL",
"first_name": "JAN",
"middle_name": "MARY",
"name_prefix": "Ms.",
"credential": "MA PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "5522",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.