NPIMap

Organization Active NPI

BST Albert Lea, LLC

  • Physical Therapy Clinic/Center
  • Albert Lea, MN
National Provider Identifier
1174107072
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
BST ALBERT LEA, LLC
Practice address
2440 Bridge Ave Ste 300
Albert Lea, MN 56007-2005
Phone
(605) 541-1140
Fax
(605) 541-0109
NPI assigned
May 7, 2021
Last updated
Mar 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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

Authorized official

Name
Stac Schmidt
Title
Provider Enrollment
Phone
(605) 541-1140

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing and Speech Clinic/Center 261QH0700X NU
Physical Therapy Clinic/Center 261QP2000X NU Primary
Occupational Medicine Clinic/Center 261QX0100X NU

Addresses

Primary practice location

2440 Bridge Ave Ste 300
Albert Lea, MN 56007-2005

Mailing address

500 Cross St
Big Stone City, SD 57216-8237
Phone (605) 541-1140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211015000279 MN Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4981002342 Receives reassigned benefits from 6 practitioners
Practice locations: Albert Lea, MN

National Provider Directory

National Provider Directory

Locations

2440 Bridge Ave
Ste 300
Albert Lea, MN 56007
Phone (507) 552-0022

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648080000000",
    "number": "1174107072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CROSS ST",
            "city": "BIG STONE CITY",
            "state": "SD",
            "postal_code": "572168237",
            "telephone_number": "605-541-1140",
            "fax_number": "605-541-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 BRIDGE AVE STE 300",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560072005",
            "telephone_number": "605-541-1140",
            "fax_number": "605-541-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BST ALBERT LEA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-07",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "STAC",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "605-541-1140"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albert Lea, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.