Larry Reed

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

800 Issued in MN

Practice address

623 Madison St
Brainerd, MN 56401-4518

Phone

(218) 829-5380

Fax

(218) 825-0972

NPI assigned

Sep 19, 2007

Sex

Male

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dean G Renneke, DC, PA

  • Chiropractor
  • Brainerd, MN
  • NPI 1619921210
  NPD (past)
• The Renneke Chiropractic Clinic PA

  • Chiropractor
  • Brainerd, MN
  • NPI 1245638584

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190160000000",
    "number": "1124214697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 MADISON ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564014518",
            "telephone_number": "218-829-5380",
            "fax_number": "218-825-0972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 MADISON ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564014518",
            "telephone_number": "218-829-5380",
            "fax_number": "218-825-0972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REED",
        "first_name": "LARRY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-19",
        "last_updated": "2007-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "088H2RE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "6406206",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine E Rangen, PHARM D
• Teah Gloria Mae Rardin, OT
• Maria Josephine Rauch, LPN
• Redebaugh Chiropractic, P.a.
• Redefyne
• Jalita Rene Reeder, RN
• Reflections Therapy and Wellness PLLC
• Angela Remmick
• Dean Glenn Renneke, DC
• Michael Reyes

• Physical Therapist in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; 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.