John Byron Radzak

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

3727 Split Rock Lighthouse Rd
Two Harbors, MN 55616-2020

Phone

(218) 220-0111

NPI assigned

Dec 26, 2009

Last updated

Dec 26, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1261785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261785600000",
    "number": "1215267141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3727 SPLIT ROCK LIGHTHOUSE RD",
            "city": "TWO HARBORS",
            "state": "MN",
            "postal_code": "556162020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3727 SPLIT ROCK LIGHTHOUSE RD",
            "city": "TWO HARBORS",
            "state": "MN",
            "postal_code": "556162020",
            "telephone_number": "218-220-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADZAK",
        "first_name": "JOHN",
        "middle_name": "BYRON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-26",
        "last_updated": "2009-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Lynn Phipps-Poe, P.T.
• Heather Pipes, LPMA
• Premise Health of Minnesota Medical P C (LP Health Center-Two Harbors)
• Adriana Quadhamer
• Carie Ann Radabaugh, RDH
• Kathleen Faye Ray, RN
• Shana Lea Roberts, MSW, LICSW
• Susan Marie Rosette
• Kelsey May Schultz, M.D.
• Lanna L Schwab, LAC

• Occupational Therapist in Two Harbors, MN
• Providers in Two Harbors, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2009; 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.