Teri J Brekke, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1162 Issued in ND

Practice address

1401 13TH Ave E
West Fargo, ND 58078-3468

Phone

(701) 364-5751

Fax

(701) 364-5750

NPI assigned

May 19, 2006

Last updated

Apr 25, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Innovis Health, LLC

  dba Essentia Health Fargo

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1215125463
  Medicare reassignment NPD
• Innovis Health, LLC.

  dba Essentia Health Lisbon Clinic

  • Family Medicine Physician
  • Lisbon, ND
  • NPI 1043490790
  NPD

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335312000000",
    "number": "1023062619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6001",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581086001",
            "telephone_number": "701-364-5751",
            "fax_number": "701-364-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 13TH AVE E",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580783468",
            "telephone_number": "701-364-5751",
            "fax_number": "701-364-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREKKE",
        "first_name": "TERI",
        "middle_name": "J",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2012-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "1162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51096",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN LIC #",
            "identifier": "6436",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS #",
            "identifier": "HP62323",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Rae Bosh
• Zachary Mathew Bowe
• Olivia Boyd
• Rose I Brakke, AUD
• Brenda Leigh Bratton, PHD
• Susan Lynn Brenan, R.PH.
• Bridging the Gap
• Erika Rae Briggs, OTR/L
• Brighter Care LLC
• Shea Brogren, OTR

• Physical Therapist in West Fargo, ND
• Providers in West Fargo, ND by specialty
• Physical Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.