Individual provider Active NPI

Catherine Ann Thompson, PTA

  • Physical Therapy Assistant
  • Saint Cloud, MN
National Provider Identifier
1063390185
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A643 Issued in MN
Practice address
2904 Roosevelt Rd Ste 1
Saint Cloud, MN 56301-9109
Phone
(320) 558-8315
Fax
(320) 558-8380
NPI assigned
Aug 26, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A643 MN Primary

Addresses

Primary practice location

2904 Roosevelt Rd Ste 1
Saint Cloud, MN 56301-9109

Mailing address

2904 Roosevelt Rd Ste 1
Saint Cloud, MN 56301-9109
Phone (320) 558-8315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A643MNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Grazia, LLC CurrentSince Sep 3, 2025 Accepting new patients

Locations

2904 Roosevelt Rd
Ste 1
Saint Cloud, MN 56301
Phone (320) 558-8315

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1756166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1063390185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2904 ROOSEVELT RD STE 1",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563019109",
            "telephone_number": "320-558-8315",
            "fax_number": "320-558-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2904 ROOSEVELT RD STE 1",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563019109",
            "telephone_number": "320-558-8315",
            "fax_number": "320-558-8380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "CATHERINE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-26",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MN",
            "license": "A643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.