Kelly Lynn Burgner, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11649 Issued in MN

Practice address

1204 Cloquet Ave
Cloquet, MN 55720-1622

Phone

(218) 878-0805

NPI assigned

Sep 19, 2019

Last updated

Sep 19, 2019By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Group practices

Fond Du Lac Reservation Business CommitteeGroup PAC ID 6608775879, 40 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

78.26 of 100Reported as group

Quality

80.41

Promoting interoperability

80

Improvement activities

40

Cost

53.23

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.burgner.p1@direct.fonddulachsd.nextgenshare.com

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.

• Fond Du Lac Reservation Business Committee

  dba Fond du Lac Human Services Division

  • Clinic/Center
  • Cloquet, MN
  • NPI 1326053166
  Medicare reassignment Care Compare group NPD
• Fond Du Lac Reservation Business Committee

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cloquet, MN
  • NPI 1053772087
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1326698531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 CLOQUET AVE",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201622",
            "telephone_number": "218-878-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 CLOQUET AVE",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201622",
            "telephone_number": "218-878-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGNER",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-19",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Cloquet",
            "affiliation": "N",
            "address_1": "1204 Cloquet Ave",
            "city": "Cloquet",
            "state": "MN",
            "country_code": "US",
            "postal_code": "557201622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brightwater Health Dba Human Development Center
• Rachel D Broadway, LICSW
• Aaron Bucci
• Michelle Buhler
• Valerie L. Burgett, RN, CNP
• Kristi M Burton, MSW, LICSW
• Leann Mae Butler, NP
• Paige Marie Carlson, APRN, CNP
• Sarah Michelle Carlson, MD
• Carlton Co Public Health & Human Services

• Physical Therapist in Cloquet, MN
• Providers in Cloquet, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; 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.

Verify at the official NPI Registry.