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Brydon Thomas Wanner

Specialist β€’ Moorhead, MN

Active NPI 1275267932 Individual Practitioner Male Practitioner
Practice location in NPPES

1505 30th Ave S
Moorhead, MN 565605149

Call 2182874338 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1505 30th Ave S

Moorhead, MN 565605149

Telephone 2182874338
Organization at the Same NPPES Address or Phone
Solutions Behavioral Healthcare Professionals, Pc Facility NPI 1801909239

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Los Angeles, CA. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2022

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Moorhead and Minnesota

206 active clinicians are listed under Specialist with a practice address in Moorhead, MN (857 in Minnesota).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Moorhead

0% of these 206 clinicians have the CMS telehealth indicator.

0% of these 206 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-09-12
Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Marriage & Family Therapist

NUCC Taxonomy Code: 106H00000X

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

Rehabilitation Counselor

NUCC Taxonomy Code: 225C00000X

An individual trained and educated in a systematic process of assisting persons with physical, mental, developmental, cognitive, and emotional disabilities to achieve their personal, career, and independent living goals assessment and appraisal, diagnosis and treatment planning, career (vocational) counseling, individual and group counseling interventions for adjustments to the medical and psychosocial impact of disability, case management, program evaluation and research, job analysis and placement counseling, and consultation on rehabilitation resources and technology. Certification generally requires a Master's degree with specialized courses in rehabilitation processes and technology.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Minnesota Board of Medical Practice.
Look Up on State Board Site

Secondary Practice Locations

1355 S Hill St

Los Angeles, CA 900153012

Phone: 2133895820

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
NPI 1013089937

Master of Education

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location September 12, 2024

Registered at 1505 30TH AVE S, MOORHEAD, MN 565605149 (Tel: 2182874338)

πŸ“
Updated Business Mailing Address September 12, 2024

Registered at 1547 30TH AVE S, MOORHEAD, MN 565605149 (Tel: 2182874338)

🏒
Secondary Practice Location Registered September 12, 2024

Additional practice office at 1355 S Hill St, Los Angeles, CA 900153012

βœ…
NPI Profile Active July 10, 2022

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 10, 2022

Registered at 1355 S HILL ST, LOS ANGELES, CA 900153012 (Tel: 2133895820)

πŸ“
Business Mailing Address (Initial Record) July 10, 2022

Registered at 1355 S HILL ST, LOS ANGELES, CA 900153012 (Tel: 2133895820)

πŸ‘€
Provider Name / Credentials (Initial Record) July 10, 2022

Recorded as BRYDON WANNER

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 10, 2022

Marriage & Family Therapist

🟒
Initial NPI Registration & Enumeration July 10, 2022

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1275267932
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 10, 2022
Last Update: September 12, 2024
Sole Proprietor: Yes

Mailing Address

1547 30th Ave S

Moorhead, MN 565605149

Phone: 2182874338

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.