Todd Christian Callan, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10219 Issued in MN

Practice address

1810 Minnesota Blvd
Saint Cloud, MN 56304-2436

Phone

(320) 229-8300

NPI assigned

Jan 14, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1336789742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 MINNESOTA BLVD",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563042436",
            "telephone_number": "320-229-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 MINNESOTA BLVD",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563042436",
            "telephone_number": "320-229-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1009 10th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Sauk Rapids",
            "state": "MN",
            "postal_code": "563799448",
            "country_code": "US",
            "telephone_number": "320-266-7338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLAN",
        "first_name": "TODD",
        "middle_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-14",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MINNESOTA BOARD OF PHYSICAL THERAPY",
            "identifier": "10219",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laracious K. Butler
• Mackenzie Butler, DNP, RN
• Michael Kevin Butts, MD
• Joia Byrnes Tellez
• Molly Callahan, RN
• Ellen Janice Calvert, MS LP LICSW LADC
• Camille Madsen LLC
• Damon Marc Campbell, M.D.
• Rebecca K. Campbell, MD
• Sonja Irene Campbell

• Physical Therapist in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.