Individual provider Active NPI

Brian Joseph Lynch, DPT

  • Physical Therapist
  • Moorhead, MN
National Provider Identifier
1629209796
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2593 Issued in MN
Practice address
801 Belsly Blvd
Moorhead, MN 56560-5055
Phone
(218) 364-6800
Fax
(218) 233-9267
NPI assigned
Aug 6, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2593 MN Primary

Addresses

Primary practice location

801 Belsly Blvd
Moorhead, MN 56560-5055

Mailing address

2400 St Francis Dr
Breckenridge, MN 56520-1025
Phone (218) 643-0345

Other practice location 1

2400 St Francis Dr
Breckenridge, MN 56520-1025
Phone (218) 643-0345 ext. 351

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

State licenses

LicenseStateTypeSpecialty
2593MNMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1629209796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 ST FRANCIS DR",
            "city": "BRECKENRIDGE",
            "state": "MN",
            "postal_code": "565201025",
            "telephone_number": "218-643-0345",
            "fax_number": "218-643-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BELSLY BLVD",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605055",
            "telephone_number": "218-364-6800",
            "fax_number": "218-233-9267"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 St Francis Dr",
            "address_purpose": "LOCATION",
            "city": "Breckenridge",
            "state": "MN",
            "postal_code": "565201025",
            "country_code": "US",
            "telephone_number": "218-643-0345 x351",
            "fax_number": "218-643-0853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "BRIAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-06",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "2593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorhead, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; 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.