The Resilient Athlete Center

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

45290600 Issued in ND

Legal business name

THE RESILIENT ATHLETE CENTER

Practice address

3155 Bluestem Dr # 288
West Fargo, ND 58078-8002

Phone

(701) 353-5476

NPI assigned

Jul 2, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Joshua D Jordan, PT, DPT, SCSNPI 1861766529

Title

Co-Owner

Phone

(720) 299-5398

Specialties & licenses 1

Addresses

Tax ID family

The Resilient Athlete Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• The Resilient Athlete Center

  • Physical Therapist
  • West Fargo, ND
  • NPI 1598251639
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joshua D Jordan, PT, DPT, CMTPT, CSCS

  • Physical Therapist
  • West Fargo, ND
  • NPI 1861766529
  NPD (past) Authorized official

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530489600000",
    "number": "1124514229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155 BLUESTEM DR # 288",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580788002",
            "telephone_number": "701-353-5476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3155 BLUESTEM DR # 288",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580788002",
            "telephone_number": "701-353-5476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE RESILIENT ATHLETE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-02",
        "last_updated": "2018-07-02",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "720-299-5398",
        "authorized_official_credential": "PT, DPT, SCS"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "ND",
            "license": "45290600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Cataract Vision Institute LLC
• The Healing Tree LLC
• The Lasik Vision Institute LLC
• The Perry Center
• The Prescription Shop Inc
• The Resilient Athlete Center
• Rachel Thiel, LPCC
• Hannah Thingelstad
• Jimmy Thomas
• Sahr Thomas

• Physical Therapy Clinic/Center in West Fargo, ND
• Providers in West Fargo, ND by specialty
• Physical Therapy Clinic/Center in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.