McKenzie Dvorak, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2189 Issued in ND

Practice address

3175 Sienna Dr S Ste 103
Fargo, ND 58104-8910

Phone

(701) 532-1906

Fax

(701) 532-1896

NPI assigned

Aug 30, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, KY2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elevation Therapy LLCGroup PAC ID 2062832629, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Elevation Therapy, LLC

  • Physical Therapist
  • Middlesboro, KY
  • NPI 1932714888

  KY, Physical Therapist, TN

  Medicare reassignment Care Compare group NPD
• Pinnacle Performance Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Harrogate, TN
  • NPI 1316338213
  NPD

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1275015877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 SIENNA DR S",
            "address_2": "STE 103",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048910",
            "telephone_number": "701-532-1906",
            "fax_number": "701-532-1896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3175 SIENNA DR S STE 103",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048910",
            "telephone_number": "701-532-1906",
            "fax_number": "701-532-1896"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3060 Frontier Way S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581048909",
            "country_code": "US",
            "telephone_number": "701-232-2340",
            "fax_number": "701-232-2330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DVORAK",
        "first_name": "MCKENZIE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "2189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brook Durkin
• Qasim K Durrani, MD
• Amy J Duscher, PT
• Clarissa Marie Dutton
• Padmaraj Dattatrey Duvvuri, MD
• Natalie Frances Dvorak, M.D.
• Dynamics Chiropractic & Rehab LLC
• Marian Dyne, CNA
• Jayla Renae Eagleson, M.S. CCC/SLP
• Phyllis Eason, M.D.

• All providers in Fargo, ND
• Physical Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.