Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brett David Lackie, DPT

Individual provider Physical Therapist · NPI 1457812307

Brett David Lackie, DPT is a Physical Therapist in Private Practice in Roseville, Minnesota. Graduated from University of Minnesota Medical School in 2018, 8 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
8
Trained at
University of Minnesota Medical School
Licensed in
MN
In the registry since
2019
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

3050 Centre Pointe Dr
Roseville, MN 55113
Phone: (952) 831-8742
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 11403 (MN)

Record details

NPI number1457812307
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedMarch 25, 2019
Last updated in NPPESJanuary 27, 2026
Certification dateJanuary 27, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolUNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated 2018 (8 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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