Charles Edward Habermann, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10540 Issued in MN

Practice address

4791 County Road 10 Ste 102
Moose Lake, MN 55767-9221

Phone

(218) 485-2020

Fax

(218) 485-2044

NPI assigned

Aug 31, 2016

Last updated

Apr 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, 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

Therapy Partners IncGroup PAC ID 4486552593, 135 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Therapy Partners, Inc.

  • Multi-Specialty Clinic/Center
  • Saint Paul, MN
  • NPI 1407809494

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Elite Physical Therapy of Southwest Florida Inc

  • Physical Therapy Clinic/Center
  • Naples, FL
  • NPI 1063687416

  Physical Therapist

  Medicare reassignment NPD
• Therapy Partners Inc

  • Physical Therapist
  • Forest Lake, MN
  • NPI 1821179607
  NPD

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1992251839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 MINNEHAHA AVE W STE 300",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041033",
            "telephone_number": "651-748-4338",
            "fax_number": "651-748-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4791 COUNTY ROAD 10 STE 102",
            "city": "MOOSE LAKE",
            "state": "MN",
            "postal_code": "557679221",
            "telephone_number": "218-485-2020",
            "fax_number": "218-485-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABERMANN",
        "first_name": "CHARLES",
        "middle_name": "EDWARD",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-31",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT36727",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Wayne Gilbertson, PA-C
• Sharon Elaine Gossett, MD
• Jaclyn L Granfors
• Mark Conrad Gregerson, MD
• Michael Gunnarson, DDS
• Allie Marie Hakamaki, DPT
• Keri A Halverson, CCC/SLP
• Ashley Lynae Hamblin, OD
• Anna Rose Hamner, RN
• April M Hansen, OTR/L

• Physical Therapist in Moose Lake, MN
• Providers in Moose Lake, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.