Individual provider Active NPI

Brian Russell Linville, PT

  • Physical Therapist
  • Eagan, MN
National Provider Identifier
1427468735
Registry record updated Mar 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10994 Issued in MN
Practice address
2645 Vikings Cir
Eagan, MN 55121-1000
Phone
(952) 456-7600
Fax
(952) 456-7601
NPI assigned
May 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11805 AZ
Physical Therapist 225100000X 10994 MN Primary

Addresses

Primary practice location

2645 Vikings Cir
Eagan, MN 55121-1000

Mailing address

4200 Dahlberg Dr Ste 300
Golden Valley, MN 55422-4841
Phone (763) 520-7870

Other identifiers 1

IdentifierTypeStateIssuer
065467MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180420002482 MN Practitioner - Physical Therapist in Private Practice 2668693029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7520SCMDMental Health Counselor
11805AZMDPhysical Therapist
10994MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Mar 26, 2018 Accepting new patients
Infinite Health Collaborative, PA Physical Therapist CurrentSince Mar 26, 2018 Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients

Locations

2645 Vikings Cir
Ste 200
Eagan, MN 55121
Phone (952) 456-7600

4100 Minnesota Dr
Edina, MN 55435
Phone (952) 456-7000

4010 W 65th St
Minneapolis, MN 55435
Phone (952) 456-7000

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600

2645 Vikings Cir
Saint Paul, MN 55121
Phone (952) 456-7600

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.

NPI Registry JSON

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

{
    "created_epoch": "1399507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1427468735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 DAHLBERG DR STE 300",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224841",
            "telephone_number": "763-520-7870",
            "fax_number": "763-520-7580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 VIKINGS CIR",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211000",
            "telephone_number": "952-456-7600",
            "fax_number": "952-456-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINVILLE",
        "first_name": "BRIAN",
        "middle_name": "RUSSELL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-08",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "11805",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065467",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; 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.