Active NPI
Kailen Halvorson, DPT
- Physical Therapist
- Northwood, ND
National Provider Identifier
1346087673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2721
- Practice address
- 4 N Park St
Northwood, ND 58267-4102 - Phone
- (701) 587-6060
- NPI assigned
- Jul 12, 2024
- Sex
- Female
- 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 | 2721 | ND | Primary |
Addresses
Primary practice location
4 N Park St
Northwood, ND 58267-4102
Mailing address
1122 21St St NW
East Grand Forks, MN 56721-2919
Phone (701) 317-5199
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2721 | ND | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720742400000",
"number": "1346087673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1122 21ST ST NW",
"city": "EAST GRAND FORKS",
"state": "MN",
"postal_code": "567212919",
"telephone_number": "701-317-5199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 N PARK ST",
"city": "NORTHWOOD",
"state": "ND",
"postal_code": "582674102",
"telephone_number": "701-587-6060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALVORSON",
"first_name": "KAILEN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-12",
"last_updated": "2024-07-12",
"certification_date": "2024-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ND",
"license": "2721",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northwood, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.