Achieve Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

ACHIEVE THERAPY LLC

Doing business as

Achieve Therapy

Practice address

829 Lake Ave
Detroit Lakes, MN 56501-3017

Phone

(218) 844-5340

NPI assigned

Mar 4, 2008

Last updated

Oct 15, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michelle D Ellis, ATC PTA

Title

Owner Office Manager

Phone

(701) 746-8374

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Achieve Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Achieve Therapy LLC

  • Physical Therapist
  • East Grand Forks, MN
  • NPI 1003145376

  O20150402000769

  Same enrollment
• Achieve Therapy LLC

  dba Achieve Therapy of Park Rapids

  • Physical Therapist
  • East Grand Forks, MN
  • NPI 1407919210

  O20150402000769

  Same enrollment

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas Carson, PT, DPT

  • Physical Therapist
  • Thief River Falls, MN
  • NPI 1134383227
  NPD
• Mathew T Grasser, PT

  • Physical Therapist
  • East Grand Forks, MN
  • NPI 1487115994
  NPD
• Sara Jane Hovde, PT

  • Physical Therapist
  • Grand Forks, ND
  • NPI 1841928215
  NPD

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539561600000",
    "number": "1578733671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12938",
            "address_2": "1425 S COLUMBIA RD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582082938",
            "telephone_number": "701-746-8374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 LAKE AVE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013017",
            "telephone_number": "218-844-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACHIEVE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-04",
        "last_updated": "2018-10-15",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER OFFICE MANAGER",
        "authorized_official_telephone_number": "701-746-8374",
        "authorized_official_credential": "ATC PTA"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MN",
            "identifier": "183H5SE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Achieve Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Achieve Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cristina Aakre
• Ethan Andrew Aho
• Jessica Ann Ailie, OTR
• Jonathan Michael Aligada, PSYD
• Elizabeth Niewojna Amaya, MED, LPCC, LCPC
• Mary Lindstrom Amundson

• Physical Therapy Clinic/Center in Detroit Lakes, MN
• Providers in Detroit Lakes, MN by specialty
• Physical Therapy Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.