Derrick Lundberg, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

Practice address

1224 2ND St NE
Minneapolis, MN 55413-1130

Phone

(612) 345-5648

NPI assigned

Nov 15, 2023

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Minnesota Integrative Health Studio

  • Acupuncturist
  • Minneapolis, MN
  • NPI 1508649039

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1700006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1982479325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2194 LEXINGTON AVE N APT 12",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134351",
            "telephone_number": "651-214-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 2ND ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131130",
            "telephone_number": "612-345-5648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "762 Cleveland Ave S",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551161347",
            "country_code": "US",
            "telephone_number": "651-214-2476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUNDBERG",
        "first_name": "DERRICK",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-15",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan J Lund, PH.D., L.P.
• Todd W Lund, DDS, MS
• Troy Christopher Lund, MD
• Ashley Elizabeth Lundberg, NP
• Becca Ebba Lundberg, CRNA
• Erica Wade Lundberg, APRN
• Jordan Rhae Lundberg, DPT
• Mary Borgerding Lundberg, PT
• Tracy Michele Lundberg, M.D.
• Hannah Lundblad

• Massage Therapist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Massage Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.

Verify at the official NPI Registry.