Braeden Nelson St.Pierre, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

3154-19 Issued in WI

Practice address

650 Birch St
Baldwin, WI 54002-9348

Phone

(715) 684-3231

NPI assigned

Mar 12, 2021

Last updated

Jul 6, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1615507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1164007969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 HALSEY ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547017201",
            "telephone_number": "715-864-9288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 BIRCH ST",
            "city": "BALDWIN",
            "state": "WI",
            "postal_code": "540029348",
            "telephone_number": "715-684-3231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST.PIERRE",
        "first_name": "BRAEDEN",
        "middle_name": "NELSON",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-12",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "3154-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elaine Marie Sorensen, L..P.N.
• St Croix Valley Shared Services
• St. Croix Orthopaedics, P.a.
• St. Croix Valley Shared Services, Inc. (ADORAY Hospice)
• St. Croix Valley Shared Services, Inc. (Adoray Home Health and Hospice)
• Holly Stainer, APNP
• Shelley Rae Stanton, M.D.
• Kaitlin Steavenson, PT
• Becky Kay Stephenson, COTA
• Joel S Stoeckeler, M.D.

• Physical Therapy Assistant in Baldwin, WI
• Providers in Baldwin, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.