Jackie L Madsen, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1527 Issued in ND

Practice address

3000 32ND Ave S
Fargo, ND 58103-6132

Phone

(701) 364-8000

Fax

(701) 364-8078

NPI assigned

May 31, 2011

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

Other names 1

• Jackie L Wardlow Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1306800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306800000000",
    "number": "1285928812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6001",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581086001",
            "telephone_number": "701-364-8000",
            "fax_number": "701-364-8078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 32ND AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036132",
            "telephone_number": "701-364-8000",
            "fax_number": "701-364-8078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADSEN",
        "first_name": "JACKIE",
        "middle_name": "L",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-31",
        "last_updated": "2011-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "1527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "WARDLOW",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hussein Abuker Madey
• Srinivasa Raghavan Madhavan, M.D.
• John Charles Madison III, MD
• Sarah Madison
• Tamara Marie Madler, LCSW, LAC, LICSW
• Jeffrey D Madsen, LAPC
• Shane Jorgen Madsen, M.D.
• Kayla Madson, MS, RD, LRD
• Jennifer L Maershbecker, AU.D.
• Tracy Lynn Maesse, LMSW

• Physical Therapist in Fargo, ND
• Providers in Fargo, ND by specialty
• Physical Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.