Randy Thomas Capelle, MPT
Individual provider Active NPI Physical Therapist · Baxter, MN
NPI 1669879730 · NPPES record last updated Mar 7, 2022
Key facts
- NPI
- 1669879730
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 6725 (MN)
- Practice address
- 15620 Edgewood Dr Ste 240
Baxter, MN 56401-6984 - Phone
- (218) 454-7012
- NPI assigned
- Dec 4, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Big Stone Therapies Baxter, LLC
Practice addresses (Care Compare)
15620 Edgewood Dr
Suite 240
Baxter, MN 56401-6984
Phone (218) 454-7012
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161223000393 | MN | Practitioner - Physical Therapist in Private Practice | 6305127713 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Big Stone Therapies Baxter, LLC | Physical Therapist | Current |
Accepting new patients |
Locations
15620 Edgewood Dr
Ste 240
Brainerd, MN 56401
Phone (218) 454-7012
309 Washington Ave
Ortonville, MN 56278
Phone (320) 839-4090
500 Cross St
Big Stone Cty, SD 57216
Phone (605) 541-1140
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6725 | MN | Yes |
Addresses
Primary practice location
15620 Edgewood Dr Ste 240
Baxter, MN 56401-6984
Mailing address
500 Cross St
Big Stone City, SD 57216-8237
Phone (605) 541-1140
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6725 | Other | MN | MN BOARD OF PHYSICAL THERAPY |
Other providers in Baxter, MN
- Adam Dean Bunte
- Natalie Rose Burdick
- Madison Rae Burtsfield
- Laura Ann Bye
- Taylor J Cadwell
- Marc Anthony Carley
- Alletha Carlson
- Jennifer Annette Carlson
- Laura Carlson
- Sara Carlson
All providers in Baxter, MN · Physical Therapist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.