Johanna Bruggeman, PT, DPT
Individual provider Active NPI Physical Therapist · Minster, OH
NPI 1316632912 · NPPES record last updated Apr 10, 2023
Key facts
- NPI
- 1316632912
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT017760 (OH)
- Practice address
- 15 N Lincoln St
Minster, OH 45865-1087 - Phone
- (419) 733-6385
- NPI assigned
- Apr 10, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
86 N Hanover St
RM 1
Minster, OH 45865-1009
Phone (419) 733-6385
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240327002712 | OH | Practitioner - Physical Therapist in Private Practice | 6507203486 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT017760 | OH | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lolek Neurologic Rehab LLC | Physical Therapist | Current |
Accepting new patients |
Locations
86 N Hanover St
Rm 1
Minster, OH 45865
Phone (419) 733-6385
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT017760 | OH | Yes |
Addresses
Primary practice location
15 N Lincoln St
Minster, OH 45865-1087
Mailing address
PO Box 26
Minster, OH 45865-0026
Phone (419) 733-6385
Other providers in Minster, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.