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NPI Code Detail

MEDICARE: MR. NICHOLAS PERRY DE GROOT RRT

MEDICARE: MR. NICHOLAS PERRY DE GROOT RRT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12279E1000XEducational Registered Respiratory Therapist

General Provider Information

NPI Number : 1184588931
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. NICHOLAS PERRY DE GROOT RRT
Provider Business Mailing Address
First Line : 609 3RD ST
Second Line :
City : FARMINGTON
State : MN
Zip : 55024-1508
Country : US
Telephone Number : 651-200-7199
Fax Number :
Provider Business Practice Location Address
First Line : 1 VETERANS DR
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55417-2309
Country : US
Telephone Number : 612-467-4411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2025
Last Update Date : 12/15/2025

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