Active NPI
Diane Marie Brickley
- Physical Therapist
- Duluth, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5160
- Practice address
- 530 E 2ND St
Duluth, MN 55805-1913 - Phone
- (218) 786-5360
- NPI assigned
- Jun 30, 2006
- Sex
- Female
- 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 | 5160 | MN | Primary |
Addresses
Primary practice location
530 E 2ND St
Duluth, MN 55805-1913
Mailing address
530 E 2ND St
Duluth, MN 55805-1913
Phone (218) 786-5360
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40431400 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4289 Ugstad Rd
Hermantown, MN 55811-3615
Phone (218) 786-3100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5160 | MN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Duluth Clinic, LTD | Current | Accepting new patients | |
| The Duluth Clinic, LTD. | Current | Accepting new patients | |
| The Duluth Clinic LTD | Current | Accepting new patients |
Locations
530 E 2nd St
Duluth, MN 55805
Phone (218) 786-5300
4621 E Superior St
Duluth, MN 55804
Phone (218) 786-3550
400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364
4289 Ugstad Rd
Hermantown, MN 55811
Phone (218) 241-8008
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Cloquet, MN
- NPI 1902563638
-
- Multi-Specialty Clinic/Center
- Duluth, MN
- NPI 1245278209
-
- Community/Retail Pharmacy
- Hinckley, MN
- NPI 1245081066
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295764520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 E 2ND ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558051913",
"telephone_number": "218-786-5360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 E 2ND ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558051913",
"telephone_number": "218-786-5360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRICKLEY",
"first_name": "DIANE",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "5160",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40431400",
"state": "WI"
}
],
"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 Jul 8, 2007; 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.