Callen S Mouritsen

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

11934 Issued in MN

Practice address

1131 S Mabelle Ave
Fergus Falls, MN 56537-3723

Phone

(218) 998-1500

NPI assigned

Jan 19, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Group practices

Total Body LLCGroup PAC ID 3476083296, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Total Body LLC

  • Physical Therapist
  • Battle Lake, MN
  • NPI 1104636299
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1013507615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N UNION AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565371212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 S MABELLE AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565373723",
            "telephone_number": "218-998-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOURITSEN",
        "first_name": "CALLEN",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-19",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MN",
            "license": "11934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce E. Money, MD
• Elizabeth S Monke, M.S., L.P.
• Wendy Moore
• Tonya Marie Mortenson, RN
• Jean Renee Moszer, LPN
• Katrina Lea Mouser, RD, LD
• Margaret Kalumba Mukula, LPN
• Gretchen Mullen
• Sarah Munick, RN
• Monica Murillo, CHW

• Physical Medicine & Rehabilitation Physician in Fergus Falls, MN
• Providers in Fergus Falls, MN by specialty
• Physical Medicine & Rehabilitation Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.