Kordae Jewell Ann Hayden

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

105 9TH Avenue SE, Ste 2
Watford City, ND 58854

Phone

(701) 842-4424

NPI assigned

Oct 9, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Homestead Physical Therapy PLLCGroup PAC ID 5496129306, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Homestead Physical Therapy PLLC

  • Physical Therapist
  • Watford City, ND
  • NPI 1184338741
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1356816128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 S BONITO WAY STE 190",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425618",
            "telephone_number": "208-287-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 9TH AVENUE SE, STE 2",
            "city": "WATFORD CITY",
            "state": "ND",
            "postal_code": "58854",
            "telephone_number": "701-842-4424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12048 Highway 23",
            "address_purpose": "LOCATION",
            "city": "Watford City",
            "state": "ND",
            "postal_code": "588549547",
            "country_code": "US",
            "telephone_number": "701-580-1267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYDEN",
        "first_name": "KORDAE",
        "middle_name": "JEWELL ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ND",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Gross
• Cassie J Haak, FNP
• David Paul Harries, MD
• Sadie Harrison
• McKayla Haugeberg
• Chantal Helde, PHARMD, BS
• Lexyn J Henderson, DPT
• London Herbert, APRN, FNP-C
• Elizabeth Holen
• Homestead Physical Therapy PLLC

• Physical Therapist in Watford City, ND
• Providers in Watford City, ND by specialty
• Physical Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; 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.