Individual provider Active NPI

Valerie Jane Hullett, PTA, CMT

  • Physical Therapy Assistant
  • Faribault, MN
National Provider Identifier
1962590638
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
1819 2ND Ave NW
Faribault, MN 55021-3035
Phone
(507) 334-9400
Fax
(507) 331-2210
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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 Primary

Addresses

Primary practice location

1819 2ND Ave NW
Faribault, MN 55021-3035

Mailing address

1381 Jefferson Rd
Northfield, MN 55057-3080
Phone (507) 646-8800

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Robert J. Erickson, P.a. CurrentSince Oct 30, 2022 Accepting new patients
Back in Action Rehab, LLP CurrentSince Oct 30, 2022 Accepting new patients

Locations

1819 2nd Ave NW
Faribault, MN 55021
Phone (507) 334-5627

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1962590638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1381 JEFFERSON RD",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550573080",
            "telephone_number": "507-646-8800",
            "fax_number": "507-646-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 2ND AVE NW",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550213035",
            "telephone_number": "507-334-9400",
            "fax_number": "507-331-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULLETT",
        "first_name": "VALERIE",
        "middle_name": "JANE",
        "name_prefix": "Miss",
        "credential": "PTA, CMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Faribault, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.