Active NPI
Brandon Clay
- Physical Therapy Assistant
- Minneapolis, MN
National Provider Identifier
1922791300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 5068
- Practice address
- 2106 2ND Ave S
Minneapolis, MN 55404-2606 - Phone
- (612) 874-1603
- NPI assigned
- May 31, 2023
- Last updated
- May 31, 2023
- Sex
- Male
- 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 Therapy Assistant | 225200000X | 5068 | MN | Primary |
Addresses
Primary practice location
2106 2ND Ave S
Minneapolis, MN 55404-2606
Mailing address
2052 Yorkshire Ave Apt 1
Saint Paul, MN 55116-2514
Phone (612) 616-7157
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 |
|---|---|---|---|
| 5068 | MN | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685491200000",
"number": "1922791300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2052 YORKSHIRE AVE APT 1",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551162514",
"telephone_number": "612-616-7157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2106 2ND AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554042606",
"telephone_number": "612-874-1603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAY",
"first_name": "BRANDON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-31",
"last_updated": "2023-05-31",
"certification_date": "2023-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MN",
"license": "5068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.