NPIMap

Organization Active NPI

Big Stone Therapies Baxter, LLC

  • Physical Therapy Clinic/Center
  • Baxter, MN
National Provider Identifier
1194020669
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
BIG STONE THERAPIES BAXTER, LLC
Practice address
15620 Edgewood Dr
Suite 240
Baxter, MN 56425
Phone
(218) 454-7012
Fax
(218) 454-7015
NPI assigned
Jan 14, 2011
Last updated
May 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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

Authorized official

Name
Angie Ackerman
Title
VP Finance and Admin
Phone
(605) 541-1144

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Hearing and Speech Clinic/Center 261QH0700X
Physical Therapy Clinic/Center 261QP2000X Primary
Occupational Medicine Clinic/Center 261QX0100X

Addresses

Primary practice location

15620 Edgewood Dr
Suite 240
Baxter, MN 56425

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
O20110503000036 MN Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2365627684 Receives reassigned benefits from 6 practitioners
Practice locations: Baxter, MN

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

15620 Edgewood Dr
Ste 240
Brainerd, MN 56401
Phone (218) 454-7012

900 Cannon Valley Dr E
Ste 118A
Northfield, MN 55057

309 Washington Ave
Ortonville, MN 56278
Phone (320) 839-4090

123 W Broadway St
Owatonna, MN 55060
Phone (507) 451-7888

Practitioners & affiliated clinicians

Practitioners 30

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.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1294963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652659200000",
    "number": "1194020669",
    "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": "15620 EDGEWOOD DR",
            "address_2": "SUITE 240",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "56425",
            "telephone_number": "218-454-7012",
            "fax_number": "218-454-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG STONE THERAPIES BAXTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-14",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A",
        "authorized_official_last_name": "ACKERMAN",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "VP FINANCE AND ADMIN",
        "authorized_official_telephone_number": "605-541-1144"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxter, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.