Individual provider Active NPI

Tom S Rotman

  • Massage Therapist
  • St Louis Park, MN
National Provider Identifier
1982279683
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Practice address
4021 Vernon Ave S Ste 210
St Louis Park, MN 55416-2802
Phone
(612) 486-2612
NPI assigned
May 25, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X Primary

Addresses

Primary practice location

4021 Vernon Ave S Ste 210
St Louis Park, MN 55416-2802

Mailing address

4021 Vernon Ave S Ste 210
St Louis Park, MN 55416-2802
Phone (612) 486-2612

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

NPI Registry JSON

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1982279683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4021 VERNON AVE S STE 210",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162802",
            "telephone_number": "612-486-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4021 VERNON AVE S STE 210",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162802",
            "telephone_number": "612-486-2612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTMAN",
        "first_name": "TOM",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-25",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.

Verify at the official NPI Registry.