Individual provider Active NPI

Kennedy Joe Pugh, PT, DPT

  • Physical Therapist
  • Jamestown, ND
National Provider Identifier
1104563527
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2469 Issued in ND
Practice address
805 5TH Ave NE
Jamestown, ND 58401
Phone
(701) 952-2739
NPI assigned
May 17, 2022
Last updated
Feb 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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 2469 ND Primary

Addresses

Primary practice location

805 5TH Ave NE
Jamestown, ND 58401

Mailing address

805 5TH Avenue Northeast
Jamestown, ND 58401
Phone (701) 952-2739

Other practice location 1

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220613002753 ND Practitioner - Physical Therapist in Private Practice 4789063280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
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)

16 S Main St
Lamoure, ND 58458-7412
Phone (701) 883-5611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2469NDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Physical Therapy and Wellness Center, PC Physical Therapist CurrentSince May 1, 2022 Accepting new patients

Locations

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

16 S Main St
Lamoure, ND 58458
Phone (701) 883-5611

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1104563527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 5TH AVENUE NORTHEAST",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "58401",
            "telephone_number": "701-952-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 5TH AVE NE",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "58401",
            "telephone_number": "701-952-2739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1420 9th St E Ste 401",
            "address_purpose": "LOCATION",
            "city": "West Fargo",
            "state": "ND",
            "postal_code": "580783381",
            "country_code": "US",
            "telephone_number": "701-364-2739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUGH",
        "first_name": "KENNEDY",
        "middle_name": "JOE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-17",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "2469",
            "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 Feb 3, 2026; 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.