Mardon Ellen So

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

13275 Issued in MN

Practice address

515 5TH Ave W
Grand Marais, MN 55604-3017

Phone

(218) 387-3040

NPI assigned

Nov 25, 2024

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

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Kitsap Physical Therapy and Sports Clinic PS IncGroup PAC ID 6507762333, 142 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment Care Compare group NPD
• Kitsap Physical Therapy and Sports Clinic PS Inc

  • Physical Therapist
  • Silverdale, WA
  • NPI 1912902347
  Medicare reassignment Care Compare group
• Multicare Health System

  • Diagnostic Radiology Physician
  • Tacoma, WA
  • NPI 1285121442
  NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Multicare Health System

  • Family Medicine Physician
  • Auburn, WA
  • NPI 1013969195

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1063238095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 5TH AVE W",
            "city": "GRAND MARAIS",
            "state": "MN",
            "postal_code": "556043017",
            "telephone_number": "218-387-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 5TH AVE W",
            "city": "GRAND MARAIS",
            "state": "MN",
            "postal_code": "556043017",
            "telephone_number": "218-387-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SO",
        "first_name": "MARDON",
        "middle_name": "ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "13275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sawtooth Mountain Clinic, Inc.
• Sawtooth Mountain Clinic, Inc.
• Milan C Schmidt, MD
• Sarah Sigford
• Grace Sliwinska-Floe
• Anna Sorensen, OTR/L
• Elizabeth Barbara Steckelberg, PT, DPT
• Steps of Change LLC
• Loren Raymond Stoner, DC
• Rebecca Sue Stoner, P.T.

• Physical Therapist in Grand Marais, MN
• Providers in Grand Marais, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.