Kaitlyn Marie Grell I, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A1975 Issued in NU

Practice address

650 S Bremer Ave
Rush City, MN 55069-9096

Phone

(320) 358-4765

NPI assigned

Mar 8, 2023

Last updated

Mar 8, 2023By the provider in NPPES

Sex

Female

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": "1678233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1316647282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50125 ACACIA LN",
            "city": "STANCHFIELD",
            "state": "MN",
            "postal_code": "550805176",
            "telephone_number": "612-987-9158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 S BREMER AVE",
            "city": "RUSH CITY",
            "state": "MN",
            "postal_code": "550699096",
            "telephone_number": "320-358-4765"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 Bremer Ave",
            "address_purpose": "LOCATION",
            "city": "Rush City",
            "state": "MN",
            "postal_code": "55069",
            "country_code": "US",
            "telephone_number": "320-358-4765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRELL",
        "first_name": "KAITLYN",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "name_suffix": "I",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-08",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NU",
            "license": "A1975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dragonfly Children's Respite Home Inc.
• Gretchen Ann Erickson, REGISTERED NURSE
• Estates at Rush City LLC
• Fairview Clinics (Fairview Clinics-Rush City)
• William G Gibson IV, FNP-C
• Diane Rose Hardee, R.N.
• Delores M Kaiserlik, RN
• William H E Kieper, DDS
• April Marie Klar, LPN
• Donna M Neumann, RN

• Physical Therapy Assistant in Rush City, MN
• Providers in Rush City, MN by specialty
• Physical Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; 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.