Brandon Pellaton, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21177 Issued in MN

Practice address

513 5TH St SW
Willmar, MN 56201-3216

Phone

(320) 214-9692

Fax

(320) 214-9924

NPI assigned

Jul 9, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• Fairview Express Care

  • Pain Clinic/Center
  • Minneapolis, MN
  • NPI 1457397150
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Greater Minnesota Family Services

  • Mental Health Counselor
  • Willmar, MN
  • NPI 1609869726
  NPD (past)
• Village Ranch Child and Family Services

  • Community/Behavioral Health Agency
  • Cokato, MN
  • NPI 1700056876
  NPD (past)

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

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404864000000",
    "number": "1689080707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1810",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562011810",
            "telephone_number": "320-214-9692",
            "fax_number": "320-214-9924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 5TH ST SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013216",
            "telephone_number": "320-214-9692",
            "fax_number": "320-214-9924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLATON",
        "first_name": "BRANDON",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-09",
        "last_updated": "2014-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Pauff
• Jessica Lynn Paulsen, LMFT
• Brian R Paulson, D.C.
• Jennilee Pearson
• Colleen Marie Pederson, LMFT
• Jennifer A Pesola, DO
• Lois Ann Peters, BSN, RN, PHN, CLC
• Rebecca Jean Petersen, LPN PE
• Brett Wayne Peterson, D.C.
• Eric Julian Peterson, CRNA,MSN

• Clinical Social Worker in Willmar, MN
• Providers in Willmar, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.