BRETT DAVID LACKIE (NPI# 1457812307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457812307 |
| Entity Type | Individual |
| Full Name | BRETT DAVID LACKIE |
| Credential | DPT |
| Practice Address |
300 Lake Dr E Chanhassen MN 55317-9302 |
| Mailing Address |
10707 Direct River Dr Nw Coon Rapids MN 55433-3922 |
| Practice Telephone | 9529934300 |
| Practice Fax Number | 9529934320 |
| Mailing Telephone | 6123854956 |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2019-03-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | 11403 | MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
300 LAKE DR E |
| City | CHANHASSEN |
| State | MN |
| Zip Code | 55317-9302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790784718 | Melissa J Mohrenweiser | Family Medicine | 300 Lake Dr E, Chanhassen, MN 55317 | 2005-07-20 |
| 1962917799 | Nicole Kristine Walker | Nurse Practitioner | 300 Lake Dr E, Chanhassen, MN 55317-9302 | 2017-12-01 |
| 1780108191 | Kelsey Ryks | Physical Therapist | 300 Lake Dr E, Chanhassen, MN 55317 | 2017-07-27 |
| 1801154752 | Jean Kathryn Tiffany | Family Medicine | 300 Lake Dr E, Chanhassen, MN 55317-9302 | 2012-04-29 |
| 1407114390 | Jennifer S Kumasaki | Internal Medicine | 300 Lake Dr E, Chanhassen, MN 55317-9302 | 2012-04-27 |
| 1144516576 | Katherine Anne Paulsen | Optometrist | 300 Lake Dr E, Chanhassen, MN 55317-9302 | 2011-06-23 |
| 1447584503 | Leah D Khan | Pediatrics | 300 Lake Dr E, Chanhassen, MN 55317-9302 | 2009-09-22 |
| 1679703284 | Vikesh Patel | Internal Medicine | 300 Lake Dr E, Chanhassen, MN 55317-9302 | 2009-07-16 |
| 1164651865 | Erin Butterfield | Pediatrics | 300 Lake Dr E, Chanhassen, MN 55317-9302 | 2009-07-02 |
| 1235371667 | Lisa Marie Elstad | Family Medicine | 300 Lake Dr E, Chanhassen, MN 55317-9302 | 2009-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801245717 | Thaddeus Sharikov | Chiropractor | 7945 Stone Creek Dr. Ste 120, Chanhassen, MN 55317 | 2016-06-10 |
| 1720461668 | Steven C Witmer | Counselor | Northstar Regional Counseling, 7945 Stone Creek Drive Suite 140, Chanhassen, MN 55317 | 2015-07-08 |
| 1194078584 | Kentaro Ishikawa | Dentist | 190 Lake Dr E, Ste 130, Chanhassen, MN 55317 | 2012-10-22 |
| 1356559983 | Rtgmedical | General Acute Care Hospital | 2186 Baneberry Way W, Chanhassen, MN 55317 | 2007-05-18 |
| 1528273299 | Cam-tu Nguyen Dalluge | Dentist | 500 West 79th Street, Radiance Dental, Chanhassen, MN 55317 | 2007-05-14 |
| 1194938910 | Sheri Hinrichs | Psychologist | 600 W. 78th St. #220, Chanhassen, MN 55317 | 2007-05-08 |
| 1891833059 | Great Plains Dental | Dentist | 500 W 79th St, Chanhassen, MN 55317 | 2007-02-01 |
| 1073665014 | Judith Aarsvold Indrelie | Psychologist | 600 West 78th Street, Chanhassen, MN 55317 | 2007-01-18 |
| 1285709410 | Diane Patricia O'grady | Psychiatry & Neurology | 7945 Stone Creek Drive, Suite 130, Chanhassen, MN 55317 | 2006-11-22 |
| 1114097425 | Michael Jeffery Leonard | Dentist | 80 West 78th Street, Chanhassen, MN 55317 | 2006-11-08 |
| Find all providers in zip 55317 | ||||
| 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 |
|---|---|---|---|---|
| 1639692296 | Kimberly Gotlund | Physical Therapist | 300 Lake Dr E Ste 1, Chanhassen, MN 55317-9302 | 2017-07-25 |
| 1255707949 | Sarah Demarest | Physical Therapist | 2901 Corporate Pl, Chanhassen, MN 55317-4560 | 2015-08-17 |
| 1629413661 | Lynne K Farrell | Physical Therapist | 8024 Cheyenne Ave, Chanhassen, MN 55317-9767 | 2013-05-03 |
| 1679883417 | Colin Rust | Physical Therapist | 600 Market St Ste 150, Chanhassen, MN 55317-4570 | 2010-10-14 |
| 1558721134 | Brandon Priebe | Physical Therapist | 7872 Century Blvd, Chanhassen, MN 55317-8005 | 2016-02-25 |
| 1578974952 | Benjamin Alan Bloomer | Physical Therapist | 600 Market St Ste 150, Chanhassen, MN 55317 | 2014-05-19 |
| 1194018853 | Jessie Nicole Stevens | Physical Therapist | 7872 Century Blvd, Chanhassen, MN 55317-8005 | 2011-05-26 |
| 1306157680 | Rachel M Hakanson | Physical Therapist | 18912 Lake Dr E, Chanhassen, MN 55317-9348 | 2010-07-01 |
| 1417185182 | Brian M Ommen | Physical Therapist | 7872 Century Blvd, Chanhassen, MN 55317-8005 | 2009-07-01 |
| 1457505596 | Linda Lee Schreck | Physical Therapist | 7945 Stone Creek Dr, Chanhassen, MN 55317-4605 | 2008-11-14 |
| Find all providers in CHANHASSEN | ||||
| City | CHANHASSEN |
| Zip Code | 55317 |
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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.