Active NPI
Sarah J Wilson, OTR/L
- Specialist
- Fargo, ND
National Provider Identifier
1295076750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 868
- Practice address
- 1711 Gold Dr S
Suite 120
Fargo, ND 58103-6416 - Phone
- (701) 451-9417
- Fax
- (701) 298-0066
- NPI assigned
- Mar 8, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 868 | ND | Primary |
Addresses
Primary practice location
1711 Gold Dr S
Suite 120
Fargo, ND 58103-6416
Mailing address
1711 Gold Dr S
Suite 120
Fargo, ND 58103-6416
Phone (701) 451-9417
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 |
|---|---|---|---|
| 868 | ND | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362700800000",
"number": "1295076750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1711 GOLD DR S",
"address_2": "SUITE 120",
"city": "FARGO",
"state": "ND",
"postal_code": "581036416",
"telephone_number": "701-451-9417",
"fax_number": "701-298-0066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1711 GOLD DR S",
"address_2": "SUITE 120",
"city": "FARGO",
"state": "ND",
"postal_code": "581036416",
"telephone_number": "701-451-9417",
"fax_number": "701-298-0066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "SARAH",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-08",
"last_updated": "2013-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "ND",
"license": "868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.