NPIMap

Organization Active NPI

Embrace Therapy Services

  • Multi-Specialty Clinic/Center
  • Fargo, ND
National Provider Identifier
1134780349
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
EMBRACE THERAPY SERVICES
Practice address
4342 15TH Ave S Ste 105
Fargo, ND 58103-1125
Phone
(701) 936-9495
Fax
(952) 222-1994
NPI assigned
Jun 27, 2019
Last updated
Jul 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Authorized official

Name
Peg Viele
Title
Billing Specialist
Phone
(701) 951-9029

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

4342 15TH Ave S Ste 105
Fargo, ND 58103-1125

Mailing address

4342 15TH Ave S Ste 105
Fargo, ND 58103-1125
Phone (701) 936-9495

Other identifiers 1

IdentifierTypeStateIssuer
1478299MedicaidND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191001001927 ND Part B Supplier - Clinic/Group Practice 1850621095 Receives reassigned benefits from 9 practitioners
Practice locations: Fargo, ND

National Provider Directory

National Provider Directory

Locations

3500 42nd St S
Fargo, ND 58104
Phone (701) 936-9495

3500 42nd St S
Ste 101
Fargo, ND 58104
Phone (701) 936-7949

4342 15th Ave S
Ste 105
Fargo, ND 58103
Phone (701) 936-9495

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689552000000",
    "number": "1134780349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4342 15TH AVE S STE 105",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031125",
            "telephone_number": "701-936-9495",
            "fax_number": "952-222-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4342 15TH AVE S STE 105",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031125",
            "telephone_number": "701-936-9495",
            "fax_number": "952-222-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBRACE THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-27",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A",
        "authorized_official_last_name": "VIELE",
        "authorized_official_first_name": "PEG",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "701-951-9029"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1478299",
            "state": "ND"
        }
    ],
    "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 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.