Active NPI
Teresa L Backus, PT
- Physical Therapist
- Cloquet, MN
National Provider Identifier
1669430625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4579
- Practice address
- 1204 Cloquet Ave
Cloquet, MN 55720-1622 - Phone
- (218) 878-0805
- NPI assigned
- May 1, 2006
- Sex
- Female
- 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 | 4579 | MN | Primary |
Addresses
Primary practice location
1204 Cloquet Ave
Cloquet, MN 55720-1622
Mailing address
425 7TH St
Cloquet, MN 55720-2020
Phone (218) 879-1705
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00404700 | Other | MEDICARE RAILROAD |
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 |
|---|---|---|---|
| 4579 | MN | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195603200000",
"number": "1669430625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "425 7TH ST",
"city": "CLOQUET",
"state": "MN",
"postal_code": "557202020",
"telephone_number": "218-879-1705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1204 CLOQUET AVE",
"city": "CLOQUET",
"state": "MN",
"postal_code": "557201622",
"telephone_number": "218-878-0805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACKUS",
"first_name": "TERESA",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-01",
"last_updated": "2007-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "4579",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00404700",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Cloquet, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.