Active NPI
Achieve Therapy LLC
- Physical Therapist
- Grand Forks, ND
National Provider Identifier
1346370640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- ACHIEVE THERAPY LLC
- Practice address
- 3035 Demers Ave
Grand Forks, ND 58201-4040 - Phone
- (701) 746-6694
- Fax
- (701) 746-6894
- NPI assigned
- Mar 6, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michelle D Ellis, ATC, PTA
- Title
- Owner
- Phone
- (701) 746-8374
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary | ||
| Occupational Therapist | 225X00000X | |||
| Physical Therapy Clinic/Center | 261QP2000X |
Addresses
Primary practice location
3035 Demers Ave
Grand Forks, ND 58201-4040
Mailing address
3035 Demers Ave
Grand Forks, ND 58201-4040
Phone (701) 746-6694
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 54651 | Medicaid | ND | |
| 6037001 | Other | ND | BCBSND |
| 135104 | Other | ND | PREFFERED ONE |
| 4970240002 | Other | ND | BCBSND |
| 006613301 | Medicaid | MN | |
| 2135134 | Other | ND | FIRST HEALTH |
| 322R6SE | Other | MN | BCBSMN |
Other names 1
- Achieve Therapy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040225000374 | ND | Part B Supplier - Clinic/Group Practice | 6608762836 |
Receives reassigned benefits from 12 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Grand Forks, ND; Minot, ND; Park River, ND |
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Achieve Therapy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Physical Therapist
- Park River, ND
- NPI 1063850436
Locations
2424 32nd Ave S
Ste 104
Grand Forks, ND 58201
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Occupational Therapist
- West Fargo, ND
- NPI 1659596096
-
- Physical Therapist
- Grand Forks, ND
- NPI 1306903729
-
- Physical Therapist
- Grand Forks, ND
- NPI 1821983297
-
- Physical Therapist
- Thief River Falls, MN
- NPI 1134383227
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1641859200000",
"number": "1346370640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3035 DEMERS AVE",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582014040",
"telephone_number": "701-746-6694",
"fax_number": "701-746-6894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3035 DEMERS AVE",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582014040",
"telephone_number": "701-746-6694",
"fax_number": "701-746-6894"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ACHIEVE THERAPY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-06",
"last_updated": "2022-01-11",
"certification_date": "2022-01-11",
"status": "A",
"authorized_official_last_name": "ELLIS",
"authorized_official_first_name": "MICHELLE",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "701-746-8374",
"authorized_official_credential": "ATC, PTA"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "54651",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSND",
"identifier": "6037001",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFFERED ONE",
"identifier": "135104",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSND",
"identifier": "4970240002",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "006613301",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "2135134",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSMN",
"identifier": "322R6SE",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Achieve Therapy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Achieve Therapy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Grand Forks, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.