Active NPI
Christopher Michael Kjolhaug, PT
- Physical Therapist
- Fergus Falls, MN
National Provider Identifier
1134604127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11382
- Practice address
- 1131 South Mabelle Ave
Fergus Falls, MN 56537 - Phone
- (218) 998-1500
- NPI assigned
- Sep 26, 2018
- Sex
- Male
- 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 | 11382 | MN | Primary |
Addresses
Primary practice location
1131 South Mabelle Ave
Fergus Falls, MN 56537
Mailing address
2970 Calico Dr S Unit F
Fargo, ND 58104-4505
Phone (218) 280-8833
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134604127 | Medicaid | MN |
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 |
|---|---|---|---|
| 11382 | MN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548115200000",
"number": "1134604127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2970 CALICO DR S UNIT F",
"city": "FARGO",
"state": "ND",
"postal_code": "581044505",
"telephone_number": "218-280-8833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1131 SOUTH MABELLE AVE",
"city": "FERGUS FALLS",
"state": "MN",
"postal_code": "56537",
"telephone_number": "218-998-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KJOLHAUG",
"first_name": "CHRISTOPHER",
"middle_name": "MICHAEL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-26",
"last_updated": "2019-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "11382",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1134604127",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fergus Falls, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.