Leighton Michael Penn

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A2692 Issued in MN

Practice address

7767 Elm Creek Blvd N Ste 160
Maple Grove, MN 55369-7078

Phone

(763) 201-8191

NPI assigned

Mar 18, 2025

Last updated

Mar 18, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1742256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1912707845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7767 ELM CREEK BLVD N STE 160",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697078",
            "telephone_number": "763-201-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7767 ELM CREEK BLVD N STE 160",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697078",
            "telephone_number": "763-201-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "LEIGHTON",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MN",
            "license": "A2692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan D. Pechauer, LMFT
• Sara Pederson, MA OTR/L
• Jennifer Ann Pelkey, OTR/L
• Michelle K. Pemble-Frazey, PHD
• Christine I Pena, L.M.F.T.
• Nina Rachel Perdue, M.D.
• Persevere Wellness LLC
• Pery Home Care LLC
• Beth Ann Pesta, PT
• Laura Linn Peters, LPCC

• Physical Therapy Assistant in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Physical Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.