Active NPI
Jessica Fossen, DPT
- Physical Therapist
- Minot, ND
National Provider Identifier
1083083208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2036
- Practice address
- 101 3Rd Ave SW
Minot, ND 58701-3880 - Phone
- (701) 857-5286
- Fax
- (701) 857-5694
- NPI assigned
- Sep 17, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2036 | ND | Primary |
Addresses
Primary practice location
101 3Rd Ave SW
Minot, ND 58701-3880
Mailing address
1015 S Broadway
Minot, ND 58701-4667
Phone (701) 857-5105
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2036 | ND | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505692800000",
"number": "1083083208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 S BROADWAY",
"city": "MINOT",
"state": "ND",
"postal_code": "587014667",
"telephone_number": "701-857-5105",
"fax_number": "701-857-5646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 3RD AVE SW",
"city": "MINOT",
"state": "ND",
"postal_code": "587013880",
"telephone_number": "701-857-5286",
"fax_number": "701-857-5694"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOSSEN",
"first_name": "JESSICA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-17",
"last_updated": "2017-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ND",
"license": "2036",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minot, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.