Active NPI
Braden Swanson, DPT
- Physical Therapist
- Minneapolis, MN
National Provider Identifier
1639692494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11719
- Practice address
- 800 E 28TH St
Minneapolis, MN 55407-3799 - Phone
- (612) 863-6029
- Fax
- (612) 863-8942
- NPI assigned
- Jul 24, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11719 | MN | Primary |
Addresses
Primary practice location
800 E 28TH St
Minneapolis, MN 55407-3799
Mailing address
7356 Niagara LN N
Maple Grove, MN 55311-2655
Phone (402) 631-3196
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11719 | MN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585785600000",
"number": "1639692494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7356 NIAGARA LN N",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553112655",
"telephone_number": "402-631-3196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E 28TH ST",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554073799",
"telephone_number": "612-863-6029",
"fax_number": "612-863-8942"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWANSON",
"first_name": "BRADEN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-24",
"last_updated": "2020-04-02",
"certification_date": "2020-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "11719",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.