Lake Superior Physical Therapy Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

LAKE SUPERIOR PHYSICAL THERAPY INC

Practice address

215 N Central Ave
14B
Duluth, MN 55807-2402

Phone

(218) 625-6300

Fax

(218) 724-6700

NPI assigned

Jul 5, 2005

Last updated

Feb 25, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Terri L Wallen

Title

Business Manager

Phone

(218) 625-6300

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Richard D Crowell, PT

  • Physical Therapist
  • Duluth, MN
  • NPI 1255338265
  NPD (past)
• Jane E Worley, PT

  • Orthopedic Physical Therapist
  • Superior, WI
  • NPI 1952588659
  NPD (past)

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424822400000",
    "number": "1164429163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N CENTRAL AVE",
            "address_2": "14B",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558072402",
            "telephone_number": "218-625-6300",
            "fax_number": "218-724-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N CENTRAL AVE",
            "address_2": "14B",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558072402",
            "telephone_number": "218-625-6300",
            "fax_number": "218-724-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE SUPERIOR PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-05",
        "last_updated": "2015-02-25",
        "status": "A",
        "authorized_official_last_name": "WALLEN",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "218-625-6300"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Superior Concierge, Inc.
• Lake Superior Counseling Center
• Lake Superior Dental Associates
• Lake Superior Internal Medicine
• Lake Superior Medical Equipment Inc
• Lake Vision PLLC
• Ronald Lake, MSW LICSW
• Lakeside Dental Associates, PA
• Lakewalk Imaging, LLC
• Lakewalk Surgery Center, Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; 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.