Individual provider Active NPI

Brittany Gannarelli

  • Physical Therapist
  • Jamestown, ND
National Provider Identifier
1083021059
Registry record updated Jul 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1753 Issued in ND
Practice address
904 5TH Ave NE
Jamestown, ND 58401-3437
Phone
(701) 253-4093
Fax
(701) 253-4086
NPI assigned
Jul 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1753 ND Primary

Addresses

Primary practice location

904 5TH Ave NE
Jamestown, ND 58401-3437

Mailing address

PO Box 2168
Fargo, ND 58107-2168
Phone (701) 234-2119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141114002320 ND Practitioner - Physical Therapist in Private Practice 0143442749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apex Physical Therapy and Wellness Center PCGroup PAC ID 6507926235, 33 clinicians

Practice addresses (Care Compare)

1420 9TH St E
Suite 401
West Fargo, ND 58078-3381
Phone (701) 364-2739

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1753NDMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Physical Therapy and Wellness Center, PC Physical Therapist CurrentSince May 20, 2021 Accepting new patients

Locations

805 5th Ave NE
Jamestown, ND 58401
Phone (701) 952-2739

1420 9th St E
Ste 401
West Fargo, ND 58078
Phone (701) 361-2739

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": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405987200000",
    "number": "1083021059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2168",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581072168",
            "telephone_number": "701-234-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 5TH AVE NE",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584013437",
            "telephone_number": "701-253-4093",
            "fax_number": "701-253-4086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNARELLI",
        "first_name": "BRITTANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2014-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "1753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.