Active NPI
Collin Kudrna, DPT
- Physical Therapist
- Bismarck, ND
National Provider Identifier
1225397664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 4204 Boulder Ridge Rd Ste 100
Bismarck, ND 58503-6199 - Phone
- (701) 751-3064
- NPI assigned
- May 4, 2012
- Last updated
- Feb 20, 2024
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | WI | Primary |
Addresses
Primary practice location
4204 Boulder Ridge Rd Ste 100
Bismarck, ND 58503-6199
Mailing address
517 E Clairemont Ave
Eau Claire, WI 54701-6479
Other practice location 1
1040 Canada Avenue
Suite 1
Bismarck, ND 58503-1813
Phone (701) 751-3064
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1040 Canada Ave
Suite 1
Bismarck, ND 58503-1813
Phone (701) 751-3064
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.15 of 100
- Quality
- 80.27
- Improvement activities
- 40
- Cost
- 76.81
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12038 | WI | MD | Pharmacist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapy Clinic/Center
- Bismarck, ND
- NPI 1679010953
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708387200000",
"number": "1225397664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "517 E CLAIREMONT AVE",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547016479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4204 BOULDER RIDGE RD STE 100",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585036199",
"telephone_number": "701-751-3064"
}
],
"practiceLocations": [
{
"address_1": "1040 Canada Avenue",
"address_2": "Suite 1",
"address_purpose": "LOCATION",
"city": "Bismarck",
"state": "ND",
"postal_code": "585031813",
"country_code": "US",
"telephone_number": "701-751-3064",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KUDRNA",
"first_name": "COLLIN",
"name_prefix": "Mr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-04",
"last_updated": "2024-02-20",
"certification_date": "2024-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bismarck, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.