Brady Sowers

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1011 Meadowlands Dr Ste 1&2
White Bear Lake, MN 55127-2339

Phone

(612) 315-1976

NPI assigned

Feb 3, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1124619952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23164 E MARTIN LAKE DR NE",
            "city": "STACY",
            "state": "MN",
            "postal_code": "550799378",
            "telephone_number": "651-261-8298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 MEADOWLANDS DR STE 1&2",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551272339",
            "telephone_number": "612-315-1976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1470 Industrial Dr NW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559010700",
            "country_code": "US",
            "telephone_number": "612-315-1976",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOWERS",
        "first_name": "BRADY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in White Bear Lake, MN
• Behavior Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; 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.