Active NPI
Ian Borgelt
- Physical Therapist
- Duluth, MN
National Provider Identifier
1235623661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 1029 W Central Entrance
Duluth, MN 55811-5477 - Phone
- (218) 624-2794
- NPI assigned
- Jun 19, 2018
- 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 | Primary |
Addresses
Primary practice location
1029 W Central Entrance
Duluth, MN 55811-5477
Mailing address
7825 3Rd St N Ste 105
Oakdale, MN 55128-5444
Phone (952) 835-4512
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529366400000",
"number": "1235623661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7825 3RD ST N STE 105",
"city": "OAKDALE",
"state": "MN",
"postal_code": "551285444",
"telephone_number": "952-835-4512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1029 W CENTRAL ENTRANCE",
"city": "DULUTH",
"state": "MN",
"postal_code": "558115477",
"telephone_number": "218-624-2794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORGELT",
"first_name": "IAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-19",
"last_updated": "2018-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Duluth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.