Individual provider Active NPI

Nora Mallow

  • Occupational Therapist
  • Fargo, ND
National Provider Identifier
1295546505
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
1461 Broadway N
Fargo, ND 58102-2622
Phone
(701) 293-6037
NPI assigned
Jan 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

1461 Broadway N
Fargo, ND 58102-2622

Mailing address

1031 29TH Ave W
West Fargo, ND 58078-7875

Other practice location 1

4319 NW Urbandale Dr
Urbandale, IA 50322-7910
Phone (515) 225-4070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250228001498 MN Practitioner - Occupational Therapist in Private Practice 2365962735 Reassigns benefits to 1 organization
I20250228002085 ND Practitioner - Occupational Therapist in Private Practice 2365962735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Balance Physical Therapy and Fitness, LLCGroup PAC ID 8820356991, 37 clinicians

Practice addresses (Care Compare)

1461 Broadway N
Fargo, ND 58102-2622
Phone (701) 293-6037

3501 8TH St S
Moorhead, MN 56560-5155
Phone (701) 293-6037

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1802NDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Balance Dietitian, LLC CurrentSince Feb 23, 2025 Accepting new patients
Total Balance Physical Therapy and Fitness, LLC Occupational Therapist CurrentSince Mar 3, 2025 Accepting new patients

Locations

3501 8th St S
Moorhead, MN 56560
Phone (218) 422-3343

1461 Broadway N
Fargo, ND 58102
Phone (701) 293-6037

2600 52nd Ave S
Fargo, ND 58104
Phone (701) 293-6037

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1295546505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 29TH AVE W",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580787875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1461 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581022622",
            "telephone_number": "701-293-6037"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4319 NW Urbandale Dr",
            "address_purpose": "LOCATION",
            "city": "Urbandale",
            "state": "IA",
            "postal_code": "503227910",
            "country_code": "US",
            "telephone_number": "515-225-4070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLOW",
        "first_name": "NORA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "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 Feb 18, 2025; 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.