Brain Injury Association of Minnesota

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

BRAIN INJURY ASSOCIATION OF MINNESOTA

Practice address

2277 Highway 36 W Ste 200
Roseville, MN 55113-3830

Phone

(612) 378-2742

Fax

(612) 378-2789

NPI assigned

Mar 20, 2007

Organization subpart

No

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

Authorized official

Name

Brad Donaldson

Title

Chief Operations Officer

Phone

(612) 378-2742

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537142400000",
    "number": "1780709402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2277 HIGHWAY 36 W STE 200",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133830",
            "telephone_number": "612-378-2742",
            "fax_number": "612-378-2789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2277 HIGHWAY 36 W STE 200",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133830",
            "telephone_number": "612-378-2742",
            "fax_number": "612-378-2789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN INJURY ASSOCIATION OF MINNESOTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2018-09-17",
        "status": "A",
        "authorized_official_last_name": "DONALDSON",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "612-378-2742"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHCP NUMBER",
            "identifier": "532442400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Rex Brace, M.D.
• Jessica Lynn Bracken, BCBA
• Carissa Kay Bradley
• Kevin E Bradt, LADC
• Brian Bradway, PA-C
• Braincare, LLC
• Michael Anthony Branchaud, LPC
• Breakthrough Medical Supply Inc
• Grant Tyler Brekken, CRNA
• Bright Future Therapy Inc

• Case Management Agency in Roseville, MN
• Providers in Roseville, MN by specialty
• Case Management Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.