Anthony Nielsen
Individual provider Active NPI Physical Therapist · Minot Afb, ND
NPI 1104466432 · NPPES record last updated Apr 5, 2024
Key facts
- NPI
- 1104466432
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 099165 (IA)
- Practice address
- 10 Missile Ave
Minot Afb, ND 58705-5003 - Phone
- (701) 723-5095
- NPI assigned
- Jan 15, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 099165 | IA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ora Orthopedics, PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 099165 | IA | Yes |
Addresses
Primary practice location
10 Missile Ave
Minot Afb, ND 58705-5003
Mailing address
10 Missile Ave
Minot Afb, ND 58705-5003
Other providers in Minot Afb, ND
- Kyle McKelvey
- Minot Public Schools
- Karen Marie Moffitt
- Mary Maudeana Moore
- Megan Nelson
- Jasmine Gianni Nurse
- Scott Edward Olech
- Amanda Shermaine Oliver
- Ralph Bryan Pangilinan
- James Morris Passmore
All providers in Minot Afb, ND · Physical Therapist in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.