Active NPI
Bradley A Refsland, MD
- Family Medicine Physician
- Park Rapids, MN
National Provider Identifier
1174579650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 022235
- Practice address
- 705 Pleasant Ave S
Park Rapids, MN 56470-1440 - Phone
- (218) 732-2800
- Fax
- (218) 732-2874
- NPI assigned
- May 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 022235 | MN | Primary |
Addresses
Primary practice location
705 Pleasant Ave S
Park Rapids, MN 56470-1440
Mailing address
PO Box 6001
Fargo, ND 58108-6001
Phone (218) 732-2800
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0122662 | Other | MN | MEDICA # |
| 1240 | Other | ND | NDBS # |
| 261088400 | Medicaid | FM | |
| 14349RE | Other | MN | MNBS # |
| 16494 | Medicaid | MN | |
| MN100025 | Other | MN | LHS/BANNERHEALTH # |
| 142056 | Other | MN | UCARE # |
| HP19575 | Other | MN | HEALTHPARTNERS # |
| 0106055 | Other | MN | MEDICA # |
| 768714 | Other | MN | AMERICA'S PPO/ARAZ # |
| DA9031015668 | Other | MN | PREFERRED ONE # |
| 6411 | Other | MN | NDBS # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5019 | ND | MD | Pharmacist |
| 022235 | MN | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323129600000",
"number": "1174579650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6001",
"city": "FARGO",
"state": "ND",
"postal_code": "581086001",
"telephone_number": "218-732-2800",
"fax_number": "218-732-2874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 PLEASANT AVE S",
"city": "PARK RAPIDS",
"state": "MN",
"postal_code": "564701440",
"telephone_number": "218-732-2800",
"fax_number": "218-732-2874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REFSLAND",
"first_name": "BRADLEY",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-26",
"last_updated": "2011-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "022235",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA #",
"identifier": "0122662",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NDBS #",
"identifier": "1240",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "261088400",
"state": "FM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MNBS #",
"identifier": "14349RE",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "16494",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LHS/BANNERHEALTH #",
"identifier": "MN100025",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE #",
"identifier": "142056",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS #",
"identifier": "HP19575",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA #",
"identifier": "0106055",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICA'S PPO/ARAZ #",
"identifier": "768714",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE #",
"identifier": "DA9031015668",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NDBS #",
"identifier": "6411",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Park Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.