Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1275267932 Individual Practitioner Male Practitioner

Brydon Thomas Wanner

Specialist • Moorhead, MN

Professional Overview & Biography Verified Profile Summary

Brydon Wanner is a registered healthcare professional specializing in Specialist in Moorhead, MN. Practice services are available at 1505 30TH AVE S under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1505 30th Ave S

Moorhead, MN 565605149

Telephone 2182874338
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Moorhead, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 34.7 Yrs
Regional Practice Density
182 Specialists

Practicing in Moorhead, MN (877 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 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.

Secondary Practice Locations

1355 S Hill St

Los Angeles, CA 900153012

Phone: 2133895820

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Janelle Smolen

Specialist

NPI 1003211855
Ashley Ramirez

Technician, Health Information

NPI 1003339417
NPI 1003432675
NPI 1003438128
Mckenzie Johnson

Behavior Analyst

NPI 1003462201
Kaci Longtin

Specialist

NPI 1003563925

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location September 12, 2024

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

📍
Updated Business Mailing Address September 12, 2024

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

NPI Profile Active July 10, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location July 10, 2022

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

📍
Updated Business Mailing Address July 10, 2022

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

👤
Provider Name / Credentials Updated July 10, 2022

Recorded as BRYDON WANNER

🎓
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.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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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

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.