Spinal Rehab Clinics, PA

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SPINAL REHAB CLINICS, PA

Practice address

225 N Benton Dr Ste 110
Sauk Rapids, MN 56379-1575

Phone

(320) 252-2225

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Daniel T Carlson, DC

Title

Ceo President

Phone

(320) 252-2225

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Outpatient physical therapy / speech pathology certification: CCN 246576

Legal name

SPINAL REHAB CLINIC

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Sep 30, 1996

Last certification

Sep 4, 2014

Ownership / control type

Proprietary

Facility address

225 North Benton Drive
Sauk Rapids, MN 56379

Locations

Practitioners 3

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

• Stacey M Gorman, P.T.

  • Physical Therapist
  • Sauk Rapids, MN
  • NPI 1982743688
  NPD (past)
• Spencer Haag, PT

  • Physical Therapist
  • Sauk Rapids, MN
  • NPI 1740017466
  NPD (past)
• Timothy Paul Tinius, PHD

  • Clinical Psychologist
  • Usaf Academy, CO
  • NPI 1356452163
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1598896326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 N BENTON DR STE 110",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563791574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 N BENTON DR STE 110",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563791575",
            "telephone_number": "320-252-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINAL REHAB CLINICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "320-252-2225",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "23823",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "636577900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS AND BLUE SHIELD",
            "identifier": "8B401SP",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zubair Siraach
• Jesse L Skillingstad
• Stephanie Ann Skroch, OTR/L
• Jeanne Twohy Sopcinski
• Jessica Sparks, PARAMEDICAL TATTOO
• Spinal Rehab Clinics, PA
• Spinal Rehab Clinics, PA
• St Cloud Hospital
• St. Cloud Hospital
• St. Cloud Hospital

• Physical Therapist in Sauk Rapids, MN
• Providers in Sauk Rapids, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.