Maxwell Austin Sorvari

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

13210 Issued in MN

Practice address

4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522

Phone

(763) 236-6000

NPI assigned

Aug 2, 2023

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": "1690934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1922780717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7709 110TH PL N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553163278",
            "telephone_number": "763-232-3475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332522",
            "telephone_number": "763-236-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORVARI",
        "first_name": "MAXWELL",
        "middle_name": "AUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-02",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "13210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Morris Smith, PSYD LP
• Jennifer Snyder, RN
• Mona Mostafa Sonbol
• Marlys R Sorenson, CNP
• Lindsey Sorn, PHARMD
• Stephanie Hecklin Soskin, FNP-BC
• Linda Benjamin Soucie, MD
• Riley Sowle, D.C.
• Marjorie K Spartz
• Mehan Spencer

• Physical Therapist in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; 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.