Active NPI
Michel Burgess, PT
- Physical Therapist
- Jamestown, ND
National Provider Identifier
1285893867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1110
- Practice address
- 904 5TH Avenue NE
Jamestown, ND 58401-3437 - Phone
- (701) 253-4000
- Fax
- (701) 253-4040
- NPI assigned
- Jun 9, 2008
- Last updated
- Jun 9, 2008
- 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 | 1110 | ND | Primary |
Addresses
Primary practice location
904 5TH Avenue NE
Jamestown, ND 58401-3437
Mailing address
904 5TH Avenue NE
Jamestown, ND 58401-3437
Phone (701) 253-4000
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 |
|---|---|---|---|
| 1110 | ND | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212969600000",
"number": "1285893867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "904 5TH AVENUE NE",
"city": "JAMESTOWN",
"state": "ND",
"postal_code": "584013437",
"telephone_number": "701-253-4000",
"fax_number": "701-253-4040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "904 5TH AVENUE NE",
"city": "JAMESTOWN",
"state": "ND",
"postal_code": "584013437",
"telephone_number": "701-253-4000",
"fax_number": "701-253-4040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGESS",
"first_name": "MICHEL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-09",
"last_updated": "2008-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ND",
"license": "1110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamestown, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.