Active NPI
Amanda Muller
- Physical Therapist
- Fargo, ND
National Provider Identifier
1114598711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2397
- Practice address
- 201 University Dr S
Fargo, ND 58103-1775 - Phone
- (701) 239-3000
- NPI assigned
- Jul 5, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11992 | MN | |
| Physical Therapist | 225100000X | 2397 | ND | Primary |
Addresses
Primary practice location
201 University Dr S
Fargo, ND 58103-1775
Mailing address
5930 Oriole PL SE
Prior Lake, MN 55372-3331
Phone (952) 220-8501
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 |
|---|---|---|---|
| 2397 | ND | MD | General Practice Dentistry |
| 11992 | MN | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625443200000",
"number": "1114598711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5930 ORIOLE PL SE",
"city": "PRIOR LAKE",
"state": "MN",
"postal_code": "553723331",
"telephone_number": "952-220-8501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 UNIVERSITY DR S",
"city": "FARGO",
"state": "ND",
"postal_code": "581031775",
"telephone_number": "701-239-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLER",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-05",
"last_updated": "2021-07-05",
"certification_date": "2021-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "11992",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ND",
"license": "2397",
"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 Jul 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.