Individual provider Active NPI

Caitlyn Nicole Hager, DPT

  • Physical Therapist
  • Bismarck, ND
National Provider Identifier
1306154570
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1575 Issued in ND
Practice address
1655 N Grandview LN
Bismarck, ND 58503-0877
Phone
(701) 751-2020
Fax
(701) 223-2207
NPI assigned
Sep 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 37042 CA
Physical Therapist 225100000X 1575 ND Primary

Addresses

Primary practice location

1655 N Grandview LN
Bismarck, ND 58503-0877

Mailing address

1319 Eastwood St
Bismarck, ND 58504-6224

Other names 1

  • Caitlyn Nicole Zundel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111011000148 ND Practitioner - Physical Therapist in Private Practice 8325221054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jones Physical Therapy PCGroup PAC ID 9830298546, 8 clinicians

Practice addresses (Care Compare)

5120 Stockholm Loop
Bismarck, ND 58503-7505
Phone (701) 751-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 37042CAMDPhysical Therapist
1575NDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jones Physical Therapy, PC CurrentSince Jul 18, 2011 Accepting new patients
Breakthrough Physical Therapy Inc Physical Therapist PastSince Aug 6, 2019 Accepting new patients

Locations

5120 Stockholm Loop
Bismarck, ND 58503
Phone (701) 751-1055

1655 N Grandview Ln
Ste 204
Bismarck, ND 58503
Phone (701) 751-2002

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": "1285027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329955200000",
    "number": "1306154570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 EASTWOOD ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585046224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 N GRANDVIEW LN",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030877",
            "telephone_number": "701-751-2020",
            "fax_number": "701-223-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGER",
        "first_name": "CAITLYN",
        "middle_name": "NICOLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-21",
        "last_updated": "2012-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 37042",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "1575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAITLYN",
            "last_name": "ZUNDEL",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; 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.