Family Physical Therapy & Wellness Centre, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

7274 Issued in MN

Legal business name

FAMILY PHYSICAL THERAPY & WELLNESS CENTRE, INC.

Practice address

4401 Egan Dr Ste 200
Savage, MN 55378-2024

Phone

(952) 746-4162

Fax

(952) 808-3112

NPI assigned

May 25, 2007

Last updated

May 17, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brenda Ann Brewster, M.P.T.NPI 1790938918

Title

Owner

Phone

(612) 875-2739

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brenda A Brewster, P.T.

  • Physical Therapist
  • Savage, MN
  • NPI 1790938918
  Medicare reassignment NPD Authorized official
• Danielle Patricia Fisher Johnson, P.T.

  • Physical Therapist
  • Rochester, MN
  • NPI 1811973787
  NPD (past)
• Melissa T Kalisvaart, PT

  • Physical Therapist
  • Reno, NV
  • NPI 1598928293
  NPD (past)

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684281600000",
    "number": "1053522300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 EGAN DRIVE",
            "address_2": "STE 200",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "55378",
            "telephone_number": "952-746-4162",
            "fax_number": "952-808-3112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 EGAN DR STE 200",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553782024",
            "telephone_number": "952-746-4162",
            "fax_number": "952-808-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PHYSICAL THERAPY & WELLNESS CENTRE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A",
        "authorized_official_last_name": "BREWSTER",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-875-2739",
        "authorized_official_credential": "M.P.T."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MN",
            "license": "7274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "504177500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "726T3FA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Amran Farah
• Sydney Feilen
• Paul W Fiedler, DDS
• Mackenzie Lauryn Fingerhut

• Specialist in Savage, MN
• Providers in Savage, MN by specialty
• Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.