Tera Deeann Paulson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1473 Issued in ND

Practice address

430 5TH St N
Breckenridge, MN 56520-1426

Phone

(701) 242-7323

Fax

(701) 242-7797

NPI assigned

May 19, 2006

Last updated

Feb 1, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN, ND2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Evolve Therapy and Performance PLLCGroup PAC ID 3476069980, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Evolve Therapy and Performance PLLC

  • Physical Therapist
  • Hankinson, ND
  • NPI 1558163147
  Medicare reassignment Care Compare group NPD Authorized official
• Orthopedic & Sports Physical Therapy, Inc

  • Multi-Specialty Clinic/Center
  • Breckenridge, MN
  • NPI 1811923535

  Physical Therapist

  Medicare reassignment NPD
• Orthopedic & Sports Physical Therapy Inc.

  • Physical Therapist
  • Hankinson, ND
  • NPI 1225215338
  Medicare reassignment NPD
• Orthopedic & Sports Physical Therapy, Inc.

  • Multi-Specialty Clinic/Center
  • Fergus Falls, MN
  • NPI 1992224331
  NPD

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296518400000",
    "number": "1609829621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 5TH ST N",
            "city": "BRECKENRIDGE",
            "state": "MN",
            "postal_code": "565201426",
            "telephone_number": "701-242-7323",
            "fax_number": "701-242-7797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 5TH ST N",
            "city": "BRECKENRIDGE",
            "state": "MN",
            "postal_code": "565201426",
            "telephone_number": "701-242-7323",
            "fax_number": "701-242-7797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULSON",
        "first_name": "TERA",
        "middle_name": "DEEANN",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2011-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "6871",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "7835",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "1473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123437000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ness Counseling P.L.L.C.
• Nicole Ness, LICSW
• Orthopedic & Sports Physical Therapy, Inc
• Melissa Ellen Pahl, FNP
• Breanna Lynn Paulson, APRN, FNP
• Marissa Marie Perry, M.ED.
• Mata Marie Peterson, LSW, LADC
• Timoth Y John Peterson
• Jazmin Marie Reckmo
• Red River Anesthesia P C

• Physical Therapist in Breckenridge, MN
• Providers in Breckenridge, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.