Jordan Backstrom
Individual provider Active NPI Physical Therapist · Rugby, ND
NPI 1376958009 · NPPES record last updated Sep 10, 2018
Key facts
- NPI
- 1376958009
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1755 (ND)
- Practice address
- 215 Highway 2 SW Stuite 103
Rugby, ND 58368 - Phone
- (701) 351-0775
- NPI assigned
- Jun 20, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
215 Hwy 2 SW
Suite 103
Rugby, ND 58368-2407
Phone (701) 881-0105
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140829000246 | ND | Practitioner - Physical Therapist in Private Practice | 3779701917 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Backstrom Physical Therapy LLC | Current |
Accepting new patients |
Locations
215 Highway 2 SW
Ste 103
Rugby, ND 58368
Phone (701) 351-0775
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1755 | ND | Yes |
Addresses
Primary practice location
215 Highway 2 SW Stuite 103
Rugby, ND 58368
Mailing address
215 Highway 2 SW Stuite 103
Rugby, ND 58368
Other practice location 1
800 S Main Ave
Rugby, ND 58368-2118
Phone (701) 776-5261 ext. 2453
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1987654321 | Medicaid | ND |
Other providers in Rugby, ND
- Karen A Alme
- Altru Health System
- Jill Marie Armstrong
- Rose Marie Armstrong
- Backstrom Physical Therapy LLC
- Beloved Hope Care Incorporated
- Carol A Berg
- Nichole Block
- Teresa Ann Block
- Twyla Regina Bohl X
All providers in Rugby, ND · Physical Therapist in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.