Individual provider Active NPI

Cassie J. Skalicky

  • Specialist
  • Fargo, ND
National Provider Identifier
1033715735
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
505 Broadway N Ste 206
Fargo, ND 58102-4489
Phone
(701) 356-7836
NPI assigned
Dec 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

505 Broadway N Ste 206
Fargo, ND 58102-4489

Mailing address

4410 Sunrise Dr
West Fargo, ND 58078-8296
Phone (701) 405-3838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rebuilding Together of Fargo-Moorhead Area, Inc. CurrentSince Sep 10, 2023 Accepting new patients

Locations

505 Broadway N
Ste 206
Fargo, ND 58102
Phone (701) 356-7836

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1033715735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 SUNRISE DR",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580788296",
            "telephone_number": "701-405-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 BROADWAY N STE 206",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024489",
            "telephone_number": "701-356-7836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKALICKY",
        "first_name": "CASSIE",
        "middle_name": "J.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-08",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.