Nicole Elizabeth Swain, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1885 Issued in ND

Practice address

3120 4TH Ave NW
Minot, ND 58703-2811

Phone

(701) 839-1311

NPI assigned

Nov 23, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nicole Elizabeth Shade Former name

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• 360 Physical Therapy

  • Physical Therapist
  • Minot, ND
  • NPI 1801463013

  Occupational Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1637625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1356008452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 8TH AVE NW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587031703",
            "telephone_number": "717-919-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 4TH AVE NW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587032811",
            "telephone_number": "701-839-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAIN",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-23",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "1885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "SHADE",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sandra K Sund, NP
• John Sundsbak
• Sunrise Counseling Services PLLC
• Sunshine Pediatric Therapy, PLLC
• Robert Super Jr.
• Jodi Swedlund
• Laura J Sweet
• Bruce B Swenson, MD
• Charles H Swenson, MD
• Jessica Swenson

• Occupational Therapist in Minot, ND
• Providers in Minot, ND by specialty
• Occupational Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; 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.

Verify at the official NPI Registry.