Integrated Body Therapies, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA8782 Issued in FL

Legal business name

INTEGRATED BODY THERAPIES, INC.

Practice address

1901 Fredeen Rd
New Brighton, MN 55112-2412

Phone

(651) 653-0786

Fax

(651) 762-7944

NPI assigned

Jan 25, 2013

Organization subpart

No

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

Authorized official

Name

Barry E Wolf, MS

Title

Billing Manager

Phone

(612) 867-2734

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edwinna Gates Sackariason, LMT

  • Massage Therapist
  • New Brighton, MN
  • NPI 1437467107
  NPD (past)

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

{
    "created_epoch": "1359072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359072000000",
    "number": "1477891471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 FREDEEN RD",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551122412",
            "telephone_number": "651-653-0786",
            "fax_number": "651-762-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 FREDEEN RD",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551122412",
            "telephone_number": "651-653-0786",
            "fax_number": "651-762-7944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED BODY THERAPIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-25",
        "last_updated": "2013-01-25",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "612-867-2734",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "MA8782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ABMP",
            "identifier": "103503",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCTMB",
            "identifier": "7068-00",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scot Montgomery Hunter, MA, LP
• Brianna Hursey, RBT
• Khadra Ibrahim
• Idimo Medical Supply
• Stacey Ann Ihle, M.A.,CCC-SLP
• Megan Christine Isaacs, PTA
• Isd 621
• Abdirisak Ismail
• Ruqiya Yusuf Isse, RN
• Heather Ites, LPCC, LADC

• Specialist in New Brighton, MN
• Providers in New Brighton, MN by specialty
• Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2013; 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.