NPIMap

Organization Active NPI

Pokegama Physical Therapy, LLC

  • Physical Therapist
  • Grand Rapids, MN
National Provider Identifier
1487980488
Registry record updated Oct 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7528 Issued in MN
Legal business name
POKEGAMA PHYSICAL THERAPY, LLC
Practice address
19259 S Gama Beach Rd
Grand Rapids, MN 55744-4967
Phone
(218) 259-9801
NPI assigned
Oct 26, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2009

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

Authorized official

Name
Kate E Braun, MA, PTNPI 1093909574
Title
Owner/Physical Therapist
Phone
(218) 259-9801

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 7528 MN Primary

Addresses

Primary practice location

19259 S Gama Beach Rd
Grand Rapids, MN 55744-4967

Mailing address

PO Box 702
Grand Rapids, MN 55744-0702
Phone (218) 259-9801

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1256515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256515200000",
    "number": "1487980488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 702",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557440702",
            "telephone_number": "218-259-9801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19259 S GAMA BEACH RD",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557444967",
            "telephone_number": "218-259-9801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POKEGAMA PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-26",
        "last_updated": "2009-10-26",
        "status": "A",
        "authorized_official_last_name": "BRAUN",
        "authorized_official_first_name": "KATE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "218-259-9801",
        "authorized_official_credential": "MA, PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "7528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; 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.