Active NPI
Rebecca Berg, RPT
- Physical Therapist
- Elk River, MN
National Provider Identifier
1770829525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6995
- Practice address
- 403 Main St NW
Elk River, MN 55330-1533 - Phone
- (952) 955-2242
- Fax
- (952) 955-2010
- NPI assigned
- Dec 26, 2012
- 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 | 6995 | MN | Primary |
Addresses
Primary practice location
403 Main St NW
Elk River, MN 55330-1533
Mailing address
200 Lewis Ave S
Suite 200
Watertown, MN 55388-4545
Phone (952) 955-2242
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6995 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Physical Therapy Centers, Inc. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Coon Rapids, MN
- NPI 1952471336
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1356480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1356480000000",
"number": "1770829525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 LEWIS AVE S",
"address_2": "SUITE 200",
"city": "WATERTOWN",
"state": "MN",
"postal_code": "553884545",
"telephone_number": "952-955-2242",
"fax_number": "952-955-2010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "403 MAIN ST NW",
"city": "ELK RIVER",
"state": "MN",
"postal_code": "553301533",
"telephone_number": "952-955-2242",
"fax_number": "952-955-2010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERG",
"first_name": "REBECCA",
"credential": "RPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-26",
"last_updated": "2012-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "6995",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk River, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.