Individual provider Active NPI

Bradley Lowell Musser, PT

  • Physical Therapist
  • Fairmont, MN
National Provider Identifier
1184992604
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5269 Issued in MN
Practice address
717 S State St Ste 900
Fairmont, MN 56031-4400
Phone
(507) 238-4949
Fax
(507) 238-3365
NPI assigned
Dec 12, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 03401 IA
Physical Therapist 225100000X 5269 MN Primary

Addresses

Primary practice location

717 S State St Ste 900
Fairmont, MN 56031-4400

Mailing address

717 S State St Ste 900
Fairmont, MN 56031-4400
Phone (507) 238-4949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

717 S State St
Suite 900
Fairmont, MN 56031-4478

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5269MNMDChiropractor
03401IAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1184992604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 S STATE ST STE 900",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314400",
            "telephone_number": "507-238-4949",
            "fax_number": "507-238-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 S STATE ST STE 900",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314400",
            "telephone_number": "507-238-4949",
            "fax_number": "507-238-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSSER",
        "first_name": "BRADLEY",
        "middle_name": "LOWELL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-12",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "03401",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "5269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.