Active NPI
Tessa L Thomas, MPT
- Physical Therapist
- Detroit Lakes, MN
National Provider Identifier
1770524308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7686
- Practice address
- 125 Frazee St E
Detroit Lakes, MN 56501-3501 - Phone
- (218) 844-2300
- Fax
- (218) 844-2444
- NPI assigned
- Jun 8, 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 | 7686 | MN | Primary |
Addresses
Primary practice location
125 Frazee St E
Detroit Lakes, MN 56501-3501
Mailing address
PO Box 727
Detroit Lakes, MN 56502-0727
Phone (218) 844-2300
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DA9031015523 | Other | MN | PREFERRED ONE # |
| 51040 | Medicaid | MN | |
| 389K1TH | Other | MN | MNBS # |
| 6406152 | Other | MN | MEDICA # |
| HP59946 | Other | MN | HEALTHPARTNERS # |
| 00051041 | Other | MN | LHS/BANNERHEALTH # |
| 26701 | Other | MN | NDBS # |
Other names 1
- Tessa L Dissmore
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1770524308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 727",
"city": "DETROIT LAKES",
"state": "MN",
"postal_code": "565020727",
"telephone_number": "218-844-2300",
"fax_number": "218-844-2444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 FRAZEE ST E",
"city": "DETROIT LAKES",
"state": "MN",
"postal_code": "565013501",
"telephone_number": "218-844-2300",
"fax_number": "218-844-2444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "TESSA",
"middle_name": "L",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-08",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "7686",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE #",
"identifier": "DA9031015523",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "51040",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MNBS #",
"identifier": "389K1TH",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA #",
"identifier": "6406152",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS #",
"identifier": "HP59946",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LHS/BANNERHEALTH #",
"identifier": "00051041",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NDBS #",
"identifier": "26701",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TESSA",
"last_name": "DISSMORE",
"middle_name": "L",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Detroit Lakes, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.