Individual provider Active NPI

Joni Vanselow, PT

  • Specialist
  • Edina, MN
National Provider Identifier
1891796124
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2169 Issued in MN
Practice address
4010 W 65TH St
Suite 105
Edina, MN 55435-1721
Phone
(952) 285-2840
Fax
(952) 285-2830
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2169 MN Primary

Addresses

Primary practice location

4010 W 65TH St
Suite 105
Edina, MN 55435-1721

Mailing address

6933 Black Duck Dr
Lino Lakes, MN 55014-1319
Phone (651) 426-8830

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

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1891796124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6933 BLACK DUCK DR",
            "city": "LINO LAKES",
            "state": "MN",
            "postal_code": "550141319",
            "telephone_number": "651-426-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 W 65TH ST",
            "address_2": "SUITE 105",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351721",
            "telephone_number": "952-285-2840",
            "fax_number": "952-285-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANSELOW",
        "first_name": "JONI",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MN",
            "license": "2169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.