LAKE SUPERIOR PHYSICAL THERAPY INC (NPI# 1164429163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164429163 |
| Entity Type | Organization |
| Organization Name | LAKE SUPERIOR PHYSICAL THERAPY INC |
| Practice Address |
215 N Central Ave 14b Duluth MN 55807-2402 |
| Practice Telephone | 2186256300 |
| Practice Fax Number | 2187246700 |
| Mailing Telephone | 2186256300 |
| Mailing Fax Number | 2187246700 |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2015-02-25 |
| Authorized Official Name | TERRI L WALLEN (BUSINESS MANAGER) |
| Authorized Official Telephone | 2186256300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
215 N CENTRAL AVE 14B |
| City | DULUTH |
| State | MN |
| Zip Code | 55807-2402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699771337 | Greg Mcgillivray | Chiropractor | 215 N Central Ave, Duluth, MN 55807-2402 | 2005-06-27 |
| 1740634443 | Richard Olson | Pharmacist | 215 N Central Ave, Duluth, MN 55807-2402 | 2016-04-19 |
| 1598128241 | Holly Lynn Ahnen | Pharmacist | 215 N Central Ave, Duluth, MN 55807-2402 | 2016-03-31 |
| 1427411081 | Solomon Siaw Baah | Pharmacist | 215 N Central Ave, Duluth, MN 55807-2402 | 2016-03-31 |
| 1619340437 | Access Music Therapy, LLC | Music Therapist | 215 N Central Ave, Duluth, MN 55807-2402 | 2015-11-02 |
| 1609204379 | Sears Holding | Clinic/Center | 215 N Central Ave, Duluth, MN 55807-2402 | 2013-10-16 |
| 1598026759 | Susan Duckworth | Social Worker | 215 N Central Ave, Duluth, MN 55807-2402 | 2012-06-05 |
| 1922039924 | K Mart Corp | Durable Medical Equipment & Medical Supplies | 215 N Central Ave, Duluth, MN 55807-2402 | 2006-07-06 |
| 1538198494 | Maryanne Quackenbush | Social Worker | 215 N Central Ave, Duluth, MN 55807-2402 | 2006-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568918126 | Jaime Lynn Mallory | Counselor | 4000 W 9th St., Duluth, MN 55807 | 2016-09-01 |
| 1568817138 | Fathers Rise Together | Community/Behavioral Health | 319 N 22nd Ave West, Duluth, MN 55807 | 2016-05-02 |
| 1558660357 | Melissa June Huray | Counselor | 326 North Central Avenue, Duluth, MN 55807 | 2011-03-18 |
| 1376757682 | Chiropractic Health Center P A | Chiropractor | 215 North Central Ave, Duluth, MN 55807 | 2007-05-09 |
| 1639235914 | Mark Andrew Nelson Albee | Social Worker | 4214 Grand Avenue, Duluth Clinic-west, Duluth, MN 55807 | 2006-12-29 |
| 1851457758 | Northwood Children's Services, Inc. | Counselor | 4000 W 9th St, Duluth, MN 55807 | 2006-12-28 |
| 1679934012 | Rebecca Ann Peterson | Nurse Practitioner | 4325 Grand Ave, Duluth, MN 55807 | 2016-03-13 |
| 1326134529 | Jane Patricia Rudd | Family Medicine | 4212 Grand Ave, Duluth, MN 55807 | 2006-10-05 |
| 1548290257 | Kirsten I Bich | Family Medicine | 4212 Grand Ave, Essentia Health West Duluth Clinic, Duluth, MN 55807 | 2006-07-05 |
| 1033140660 | Wendell R Bonner | Family Medicine | 4212 Grand Ave, Duluth, MN 55807 | 2006-07-05 |
| Find all providers in zip 55807 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275131443 | Rv Patel, LLC. | Physical Therapist | 3293 Cambridge Ave, Duluth, GA 30096-9914 | 2020-10-11 |
| 1154932200 | Kwon Physical Therapy | Physical Therapist | 3473 Satellite Blvd # 108n, Duluth, GA 30096-8690 | 2020-08-12 |
| 1639795321 | Hailey Corradi | Physical Therapist | 526 N 12th Ave E, Duluth, MN 55805-2231 | 2020-06-18 |
| 1982264016 | Jennifer M Wraalstad | Physical Therapist | 4212 Grand Avenue, Duluth, MN 55807-2737 | 2019-06-20 |
| 1588134399 | Danielle Mcgee | Physical Therapist | 3870 Pleasant Hill Rd Ste 1, Duluth, GA 30096-4807 | 2018-12-05 |
| 1992201081 | Sarah M Jones | Physical Therapist | 1440 91st Ave W, Duluth, MN 55808-1530 | 2018-04-05 |
| 1053829390 | Kelsey Elizabeth Swales | Physical Therapist | Essentia Health Polinsky Medical Rehabilitation Center, 530 East Second Street, Duluth, MN 55805-1913 | 2018-01-22 |
| 1972011476 | James Ro | Physical Therapist | 3655 Howell Ferry Rd Ste 300, Duluth, GA 30096-3186 | 2018-01-18 |
| 1679098081 | Michael Thomas Mcknight | Physical Therapist | 3680 Pleasant Hill Rd Ste 101, Duluth, GA 30096-3268 | 2017-08-07 |
| 1801317425 | Victor Chu | Physical Therapist | 3455 Peachtree Industrial Blvd Ste 825, Duluth, GA 30096-6500 | 2017-07-05 |
| Find all providers in DULUTH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.