NPIMap

Organization Active NPI

Between the Bridges Healing Center, LLC

  • Family Medicine Physician
  • Mankato, MN
National Provider Identifier
1851470462
Registry record updated Apr 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37416 Issued in MN
Legal business name
BETWEEN THE BRIDGES HEALING CENTER, LLC
Practice address
45 Teton LN
Mankato, MN 56001-4814
Phone
(507) 388-7488
Fax
(507) 388-5680
NPI assigned
Nov 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2009

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

Authorized official

Name
Ms. Missy R Nelson
Title
Office Manager
Phone
(507) 388-7488

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 204D00000X 37416 MN
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 37416 MN Primary

Addresses

Primary practice location

45 Teton LN
Mankato, MN 56001-4814

Mailing address

45 Teton LN
Mankato, MN 56001-4814
Phone (507) 388-7488

Other identifiers 1

IdentifierTypeStateIssuer
560320000MedicaidMN

National Provider Directory

National Provider Directory

Locations

1423 N Riverfront Dr
Mankato, MN 56001
Phone (507) 625-2821

45 Teton Ln
Mankato, MN 56001
Phone (507) 388-7488

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238976000000",
    "number": "1851470462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 TETON LN",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014814",
            "telephone_number": "507-388-7488",
            "fax_number": "507-388-5680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 TETON LN",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014814",
            "telephone_number": "507-388-7488",
            "fax_number": "507-388-5680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETWEEN THE BRIDGES HEALING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2009-04-06",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "MISSY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "507-388-7488",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MN",
            "license": "37416",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "37416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "560320000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2009; 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.