Active NPI
Jon T Nordrum, PT, DPT
- Physical Therapist
- Rochester, MN
National Provider Identifier
1972576015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4518
- Practice address
- 200 1St St SW
Rochester, MN 55905-0001 - Phone
- (507) 284-2511
- NPI assigned
- Feb 9, 2006
- Sex
- Male
- Sole proprietor
- No
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 Therapist | 225100000X | 4518 | MN | Primary |
Addresses
Primary practice location
200 1St St SW
Rochester, MN 55905-0001
Mailing address
200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511
Other practice location 1
13400 E Shea Blvd
Scottsdale, AZ 85259
Phone (480) 301-6874
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 749405000 | Medicaid | MN | |
| ENROLLED | Medicaid | MN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jnordrum67174@ehrdirect.mayoclinicmsg.org |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4518 | MN | MD | Chiropractor |
Interoperability endpoints
- jnordrum67174@ehrdirect.mayoclinicmsg.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615852800000",
"number": "1972576015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 1ST ST SW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559050001",
"telephone_number": "507-284-2511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 1ST ST SW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559050001",
"telephone_number": "507-284-2511"
}
],
"practiceLocations": [
{
"address_1": "13400 E Shea Blvd",
"address_purpose": "LOCATION",
"city": "Scottsdale",
"state": "AZ",
"postal_code": "85259",
"country_code": "US",
"telephone_number": "480-301-6874",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NORDRUM",
"first_name": "JON",
"middle_name": "T",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-09",
"last_updated": "2021-03-16",
"certification_date": "2021-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "4518",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "749405000",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ENROLLED",
"state": "MN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jnordrum67174@ehrdirect.mayoclinicmsg.org",
"affiliation": "N",
"address_1": "13400 E Shea Blvd",
"city": "Scottsdale",
"state": "AZ",
"country_code": "US",
"postal_code": "85259",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.