Active NPI
John R Brown, PT
- Physical Therapist
- Burnsville, MN
National Provider Identifier
1104518265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 14451 Grand Ave
Burnsville, MN 55306-5708 - Phone
- (952) 993-5900
- NPI assigned
- May 25, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
14451 Grand Ave
Burnsville, MN 55306-5708
Mailing address
14451 Grand Ave
Burnsville, MN 55306-5708
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
14000 Fairview Dr
Burnsville, MN 55337-5713
Phone (952) 993-8700
5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13023 | MN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Park Nicollet Clinic | Current | Accepting new patients | |
| Park Nicollet Clinic | Current | Accepting new patients | |
| Park Nicollet Clinic | Past | Accepting new patients |
Locations
14451 Grand Ave S
Burnsville, MN 55306
Phone (701) 441-9496
5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400
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 and National Provider Directory roles.
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1780621904
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1063897593
-
- Clinic/Center
- St Louis Park, MN
- NPI 1275232423
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684972800000",
"number": "1104518265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14451 GRAND AVE",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553065708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14451 GRAND AVE",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553065708",
"telephone_number": "952-993-5900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "JOHN",
"middle_name": "R",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-25",
"last_updated": "2023-05-25",
"certification_date": "2023-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Burnsville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.