Active NPI
Trevor Leon Richards, PT
- Physical Therapist
- New Brighton, MN
National Provider Identifier
1881865160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7810
- Practice address
- 825 1St Ave NW
New Brighton, MN 55112-6846 - Phone
- (651) 633-7875
- Fax
- (651) 628-9335
- NPI assigned
- Mar 14, 2008
- 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 | 7810 | MN | Primary |
Addresses
Primary practice location
825 1St Ave NW
New Brighton, MN 55112-6846
Mailing address
825 1St Ave NW
New Brighton, MN 55112-6846
Phone (651) 633-7875
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7810 | MN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205452800000",
"number": "1881865160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 1ST AVE NW",
"city": "NEW BRIGHTON",
"state": "MN",
"postal_code": "551126846",
"telephone_number": "651-633-7875",
"fax_number": "651-628-9335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 1ST AVE NW",
"city": "NEW BRIGHTON",
"state": "MN",
"postal_code": "551126846",
"telephone_number": "651-633-7875",
"fax_number": "651-628-9335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDS",
"first_name": "TREVOR",
"middle_name": "LEON",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-14",
"last_updated": "2008-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "7810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Brighton, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.