Active NPI
Peter Richard Stanley, DPT
- Physical Therapist
- Le Center, MN
National Provider Identifier
1992295083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11070
- Practice address
- 444 N Cordova Ave
Le Center, MN 56057-1704 - Phone
- (507) 357-3375
- NPI assigned
- May 14, 2018
- Last updated
- May 14, 2018
- 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 | 11070 | MN | Primary |
Addresses
Primary practice location
444 N Cordova Ave
Le Center, MN 56057-1704
Mailing address
4301 Park Glen Rd Apt 230
Minneapolis, MN 55416-4786
Phone (763) 843-6664
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 |
|---|---|---|---|
| 11070 | MN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526256000000",
"number": "1992295083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 PARK GLEN RD APT 230",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554164786",
"telephone_number": "763-843-6664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "444 N CORDOVA AVE",
"city": "LE CENTER",
"state": "MN",
"postal_code": "560571704",
"telephone_number": "507-357-3375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANLEY",
"first_name": "PETER",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-14",
"last_updated": "2018-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "11070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Le Center, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.