Individual provider Active NPI

Bruce Alan Gasser, KINESIOTHERAPIST

  • Kinesiotherapist
  • Saint Cloud, MN
National Provider Identifier
1497846836
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
KinesiotherapistTaxonomy code 226300000X
License
626 Issued in MN
Practice address
4801 Veterans Dr
Saint Cloud, MN 56303-2015
Phone
(320) 252-1670
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Kinesiotherapist 226300000X 626 MN Primary

Addresses

Primary practice location

4801 Veterans Dr
Saint Cloud, MN 56303-2015

Mailing address

811 8TH Ave N
Sartell, MN 56377-2241
Phone (320) 252-8049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497846836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 8TH AVE N",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772241",
            "telephone_number": "320-252-8049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 VETERANS DR",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032015",
            "telephone_number": "320-252-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASSER",
        "first_name": "BRUCE",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "KINESIOTHERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "226300000X",
            "taxonomy_group": "",
            "desc": "Kinesiotherapist",
            "state": "MN",
            "license": "626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.