Active NPI
Nicholl Jurgens-Dinius, PT
- Physical Therapist
- Dickinson, ND
National Provider Identifier
1124129614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1324
- Practice address
- 1531 W Villard St Ste a
Dickinson, ND 58601-4651 - Phone
- (701) 225-7575
- Fax
- (701) 225-9697
- NPI assigned
- Sep 26, 2006
- 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 | 1324 | ND | Primary |
Addresses
Primary practice location
1531 W Villard St Ste a
Dickinson, ND 58601-4651
Mailing address
1531 W Villard St Ste a
Dickinson, ND 58601-4651
Phone (701) 225-7575
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23726 | Other | ND | BLUE CROSS |
| 54648 | Medicaid | ND |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1324 | ND | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254355200000",
"number": "1124129614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1531 W VILLARD ST STE A",
"city": "DICKINSON",
"state": "ND",
"postal_code": "586014651",
"telephone_number": "701-225-7575",
"fax_number": "701-225-9697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1531 W VILLARD ST STE A",
"city": "DICKINSON",
"state": "ND",
"postal_code": "586014651",
"telephone_number": "701-225-7575",
"fax_number": "701-225-9697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JURGENS-DINIUS",
"first_name": "NICHOLL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-26",
"last_updated": "2009-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ND",
"license": "1324",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "23726",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "54648",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dickinson, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.