Individual provider Active NPI

Jordan Leigh Bahr, PT

  • Physical Therapist
  • Grand Forks, ND
National Provider Identifier
1215346291
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1849 Issued in ND
Practice address
2512 S Washington St Ste C
Grand Forks, ND 58201-6772
Phone
(701) 330-4818
NPI assigned
Aug 4, 2014
Last updated
Jan 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9813 MN
Physical Therapist 225100000X 1849 ND Primary

Addresses

Primary practice location

2512 S Washington St Ste C
Grand Forks, ND 58201-6772

Mailing address

618 S 5TH St
Grand Forks, ND 58201-4614

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150108002168 ND Practitioner - Physical Therapist in Private Practice 5890018360 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1849NDMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Chelsey Kjono CurrentSince Jan 26, 2025 Accepting new patients
Little Miracles, Inc. CurrentSince Oct 1, 2018 Accepting new patients

Locations

2200 Library Cir
Grand Forks, ND 58201
Phone (701) 757-2155

2512 S Washington St
Ste C
Grand Forks, ND 58201
Phone (701) 330-4818

2951 S 34th St
Grand Forks, ND 58201
Phone (701) 772-3851

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1215346291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 S 5TH ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 S WASHINGTON ST STE C",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016772",
            "telephone_number": "701-330-4818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHR",
        "first_name": "JORDAN",
        "middle_name": "LEIGH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "9813",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "1849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.