Big Stone Therapies Fargo, Inc
Organization Active NPI Physical Therapy Clinic/Center · Fargo, ND
NPI 1194021873 · NPPES record last updated Jun 16, 2022
Key facts
- NPI
- 1194021873
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- Legal business name
- BIG STONE THERAPIES FARGO, INC
- Practice address
- 2829 University Dr S
Ste 202
Fargo, ND 58103-6050 - Phone
- (701) 478-0307
- Fax
- (701) 478-0309
- NPI assigned
- Jan 28, 2011
- Organization subpart
- No
Authorized official
- Name
- Angie Ackerman
- Title
- Administrator
- Phone
- (605) 541-1144
Member of 1
Practitioners 16
-
Casey James Hansen, D.P.T
-
Bailey Ann Odegaard, OTR/L
-
Elaine Doerfler, MS, CCC/SLP
-
Sarah E Perkerewicz, PT, DPT
-
Paige Urie, PTA
-
Majid Ghazi, MD
-
Dustin Dominic Goetz, M.D.
-
Joan Quam, APRN NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170113002544 | ND | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 3072894807 |
Receives reassigned benefits from 11 practitioners Practice locations: Fargo, ND; West Fargo, ND |
National Provider Directory
Locations
2829 University Dr S
Fargo, ND 58103
Phone (701) 232-9000
2401 41st St S
Fargo, ND 58104
Phone (701) 478-7868
645 33rd Ave E
#R
West Fargo, ND 58078
Phone (701) 551-7700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | |||
| Occupational Therapist |
225X00000X | |||
| Hearing and Speech Clinic/Center | 261QH0700X | |||
| Physical Therapy Clinic/Center | 261QP2000X | Yes | ||
| Occupational Medicine Clinic/Center | 261QX0100X |
Addresses
Primary practice location
2829 University Dr S
Ste 202
Fargo, ND 58103-6050
Mailing address
500 Cross St
Big Stone City, SD 57216-8237
Phone (605) 541-1140
Other practice location 1
2401 41st St S
Fargo, ND 58104-7783
Phone (701) 478-7868
Other practice location 2
645 33rd Ave E # R
West Fargo, ND 58078-8074
Phone (701) 551-7700
Other providers in Fargo, ND
- Sarah Jean Bieber
- Peter Biegler III
- Dennis E Bier
- Michelle Lee Bierdeman
- Christine Bietz
- Tamra Sue Bigger
- Marc J Biggerstaff
- Elena Zi Ming Bigliardi
- Beau Monte Billadeau
- Kara M Billing
All providers in Fargo, ND · Physical Therapy Clinic/Center in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.