Active NPI
Jessikay Noll
- Physical Therapy Assistant
- Dickinson, ND
National Provider Identifier
1508008863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 0847
- Practice address
- 683 State Ave Ste B
Dickinson, ND 58601-4660 - Phone
- (701) 483-9400
- NPI assigned
- Apr 1, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 0847 | ND | Primary |
Addresses
Primary practice location
683 State Ave Ste B
Dickinson, ND 58601-4660
Mailing address
683 State Ave Ste B
Dickinson, ND 58601-4660
Phone (701) 483-9400
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12229 | Other | ND | BLUE CROSS AND BLUE SHIELD |
| 52114 | Medicaid | ND |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0847 | ND | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Omaha Therapy Dba Rehab Visions | Past | Accepting new patients | |
| Omaha Therapy, Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Dickinson, ND
- NPI 1457513418
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238544000000",
"number": "1508008863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "683 STATE AVE STE B",
"city": "DICKINSON",
"state": "ND",
"postal_code": "586014660",
"telephone_number": "701-483-9400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "683 STATE AVE STE B",
"city": "DICKINSON",
"state": "ND",
"postal_code": "586014660",
"telephone_number": "701-483-9400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLL",
"first_name": "JESSIKAY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-01",
"last_updated": "2009-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "ND",
"license": "0847",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS AND BLUE SHIELD",
"identifier": "12229",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "52114",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dickinson, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.