Active NPI
Mary Kaye Guenther
- Physical Therapy Assistant
- Mound, MN
National Provider Identifier
1962992594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A1115A1115
- Practice address
- 6670 Game Farm Rd
Mound, MN 55364 - Phone
- (612) 816-2986
- NPI assigned
- May 18, 2018
- Last updated
- May 18, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A1115A1115 | MN | Primary |
Addresses
Primary practice location
6670 Game Farm Rd
Mound, MN 55364
Mailing address
6670 Game Farm Rd
Mound, MN 55364
Phone (612) 816-2986
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
| License | State | Type | Specialty |
|---|---|---|---|
| A1115A1115 | MN | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526601600000",
"number": "1962992594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6670 GAME FARM RD",
"city": "MOUND",
"state": "MN",
"postal_code": "55364",
"telephone_number": "612-816-2986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6670 GAME FARM RD",
"city": "MOUND",
"state": "MN",
"postal_code": "55364",
"telephone_number": "612-816-2986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUENTHER",
"first_name": "MARY",
"middle_name": "KAYE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-18",
"last_updated": "2018-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MN",
"license": "A1115A1115",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mound, MN
- Dynamic Chiropractic and Rehab PLLC (HealthSource Chiropractic of Mound)
- Dynamic Medical Systems, Inc.
- Kirsten Eaton
- Sarah Feerhusen
- Audrey Mae Frederickson, PSY D
- Horsing Around LLC (Game Farm Stables)
- Interactive Medical Systems, Inc.
- J M Baldus, Inc
- Macushla Colleen Kelly
- Keystone Chiropractic Health Centre PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.