NPIMap

Individual provider Active NPI

Julie Ann Newberg, PHYSICAL THERAPY AST

  • Physical Therapy Assistant
  • Saint Paul, MN
National Provider Identifier
1922289735
Registry record updated Nov 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2306601966 Issued in VA
Practice address
225 Smith Ave N
Suite 301
Saint Paul, MN 55102-2533
Phone
(651) 288-5180
Fax
(651) 288-5188
NPI assigned
Nov 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2306601966 VA Primary

Addresses

Primary practice location

225 Smith Ave N
Suite 301
Saint Paul, MN 55102-2533

Mailing address

225 Smith Ave N
Suite 301
Saint Paul, MN 55102-2533
Phone (651) 288-5180

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

State licenses

LicenseStateTypeSpecialty
2306601966VAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fueling Performance, LLC Past Accepting new patients
Medcentra LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195516800000",
    "number": "1922289735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 SMITH AVE N",
            "address_2": "SUITE 301",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022533",
            "telephone_number": "651-288-5180",
            "fax_number": "651-288-5188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 SMITH AVE N",
            "address_2": "SUITE 301",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022533",
            "telephone_number": "651-288-5180",
            "fax_number": "651-288-5188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBERG",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PHYSICAL THERAPY AST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-20",
        "last_updated": "2007-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306601966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.

Verify at the official NPI Registry.