Individual provider Active NPI

Brianna Nielsen, PT

  • Physical Therapist
  • Lisbon, ND
National Provider Identifier
1013897891
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2940 Issued in ND
Practice address
12377 69TH St SE
Lisbon, ND 58054-9614
Phone
(701) 680-7611
NPI assigned
Sep 3, 2025
Last updated
Oct 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2940 ND Primary

Addresses

Primary practice location

12377 69TH St SE
Lisbon, ND 58054-9614

Mailing address

12377 69TH St SE
Lisbon, ND 58054-9614

Other practice location 1

401 N 9th St
Bismarck, ND 58501-4530
Phone (701) 712-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251015003393 ND Practitioner - Physical Therapist in Private Practice 7113414848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovis Health LLCGroup PAC ID 9931298155, 561 clinicians

Practice addresses (Care Compare)

401 N 9TH St
Bismarck, ND 58501-4530
Phone (701) 712-4500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Innovis Health, LLC. CurrentSince Oct 1, 2025 Accepting new patients
Innovis Health LLC CurrentSince Oct 1, 2025 Accepting new patients
Innovis Health, LLC Current Accepting new patients

Locations

401 N 9th St
Bismarck, ND 58501
Phone (701) 530-6000

3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1756857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1013897891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12377 69TH ST SE",
            "city": "LISBON",
            "state": "ND",
            "postal_code": "580549614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12377 69TH ST SE",
            "city": "LISBON",
            "state": "ND",
            "postal_code": "580549614",
            "telephone_number": "701-680-7611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 N 9th St",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "585014530",
            "country_code": "US",
            "telephone_number": "701-712-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "BRIANNA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-03",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "2940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisbon, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; 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.