Active NPI
Olivia G Light, DPT
- Physical Therapist
- West Fargo, ND
National Provider Identifier
1346129483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2836
- Practice address
- 1401 13TH Ave E
West Fargo, ND 58078-3468 - Phone
- (701) 364-5751
- NPI assigned
- Sep 2, 2025
- 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 | 2836 | ND | Primary |
Addresses
Primary practice location
1401 13TH Ave E
West Fargo, ND 58078-3468
Mailing address
400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364
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 |
|---|---|---|---|
| 2836 | ND | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Innovis Health, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Fargo, ND
- NPI 1215125463
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756771200000",
"number": "1346129483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 E 3RD ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558051951",
"telephone_number": "218-786-8364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 13TH AVE E",
"city": "WEST FARGO",
"state": "ND",
"postal_code": "580783468",
"telephone_number": "701-364-5751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIGHT",
"first_name": "OLIVIA",
"middle_name": "G",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-09-02",
"last_updated": "2025-09-02",
"certification_date": "2025-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ND",
"license": "2836",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.