Individual provider Active NPI

Randy Lee Kollman, DPT

  • Physical Therapist
  • Jamestown, ND
National Provider Identifier
1437484649
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8332 Issued in MN
Practice address
904 5TH Ave NE
Jamestown, ND 58401-3437
Phone
(701) 253-4000
NPI assigned
Oct 5, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1531 ND
Physical Therapist 225100000X 8332 MN Primary

Addresses

Primary practice location

904 5TH Ave NE
Jamestown, ND 58401-3437

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

2830 5TH Ave NW
Jamestown, ND 58401-1806
Phone (701) 269-0006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111108000097 ND Practitioner - Physical Therapist in Private Practice 0547433591 Reassigns benefits to 1 organization
Practice locations: Jamestown, ND

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

904 5TH Ave NE
Jamestown, ND 58401-3437
Phone (701) 253-4000

Merit-based Incentive Payment System (MIPS)

Final score
82.73 of 100Reported as group
Quality
71.75
Promoting interoperability
100
Improvement activities
40
Cost
70.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1531NDMDRegistered Dietitian
8332MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo Current Accepting new patients
Sanford Medical Center Fargo CurrentSince Sep 26, 2024 Accepting new patients
Sanford Medical Center Fargo CurrentSince Sep 26, 2024 Accepting new patients
Sanford Medical Center Fargo Past Accepting new patients
Rehabauthority, LLC Physical Therapist PastSince Apr 1, 2021 Accepting new patients
At-Home Physical Therapy, PC Physical Therapist PastSince Mar 1, 2005 Accepting new patients

Locations

300 2nd Ave NE
Jamestown, ND 58401
Phone (701) 251-6000

904 5th Ave NE
Jamestown, ND 58401
Phone (701) 253-4000

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1254700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1437484649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 5TH AVE NE",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584013437",
            "telephone_number": "701-253-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2830 5TH AVE NW",
            "address_purpose": "LOCATION",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584011806",
            "country_code": "US",
            "telephone_number": "701-269-0006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLLMAN",
        "first_name": "RANDY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-05",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "1531",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "8332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.