Active NPI
Jeff R Howard, PT
- Physical Therapist
- Maple Grove, MN
National Provider Identifier
1871677617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3057
- Practice address
- 11671 Fountains Dr Ste 200
Maple Grove, MN 55369-4784 - Phone
- (763) 585-0600
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- 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 | 3057 | MN | Primary |
Addresses
Primary practice location
11671 Fountains Dr Ste 200
Maple Grove, MN 55369-4784
Mailing address
17266 90TH Ave N
Maple Grove, MN 55311-1481
Phone (763) 607-2257
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3057 | MN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406678400000",
"number": "1871677617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17266 90TH AVE N",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553111481",
"telephone_number": "763-607-2257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11671 FOUNTAINS DR STE 200",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553694784",
"telephone_number": "763-585-0600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOWARD",
"first_name": "JEFF",
"middle_name": "R",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2014-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "3057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maple Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.