Stephanie Branchaud, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12094 Issued in MN

Practice address

9645 Grove Cir N Ste 100
Maple Grove, MN 55369-2682

Phone

(763) 302-4114

NPI assigned

Sep 29, 2016

Sex

Female

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 CO, MN2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tria Orthopaedic Center LLCGroup PAC ID 3173570561, 504 clinicians

Practice addresses (Care Compare)

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.

• Tria Orthopaedic Center LLC

  • Orthopaedic Surgery Physician
  • Bloomington, MN
  • NPI 1518273085

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Coal Creek Physical Therapy, LLC

  • Physical Therapist
  • Louisville, CO
  • NPI 1740238120
  Medicare reassignment NPD
• Coal Creek Diagnostics, LLC

  • Diagnostic Ultrasound Physician
  • Louisville, CO
  • NPI 1366941171
  NPD (past)

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

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1831648922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9645 GROVE CIR N STE 100",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553692682",
            "telephone_number": "763-302-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9645 GROVE CIR N STE 100",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553692682",
            "telephone_number": "763-302-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANCHAUD",
        "first_name": "STEPHANIE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-29",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "12094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Boykin, PHD
• Rachel Boyle, PSY.D
• Bradie Nest Care
• Jerusha Clare Brager, P.T.
• Cali Lynn Branch
• Joel Keith Branes, D.C.
• Diane Branson
• Brenda Diane Brant, PSY.D., ED.S., L.P.
• Nicole Jacklyn Breault
• Jennifer Bremer, RD, LD

• Physical Therapist in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.