My PT, PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

1472 Issued in ND

Legal business name

MY PT, PLLC

Practice address

1800 21St Ave S
Fargo, ND 58103-5759

Phone

(701) 367-2495

NPI assigned

Mar 14, 2017

Organization subpart

No

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

Authorized official

Name

Scott Brown

Title

Owner

Phone

(701) 367-2495

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489449600000",
    "number": "1528509288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4132 S RIVERSHORE DR",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565605627",
            "telephone_number": "701-367-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 21ST AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581035759",
            "telephone_number": "701-367-2495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY PT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-14",
        "last_updated": "2017-03-14",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-367-2495"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "ND",
            "license": "1472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farhad Mustafa
• Dami Mustapha
• Amber Nicole Mutalipassi, LCSW
• Scott Bradley Mutchler, MD
• Sheila Muus, LPC
• Leslie Anne Myer, OTR/L
• Faith Myers
• Graysen Myers, MD
• Jennifer Myers, MD
• Kimberly R Myers, MSCCC-SLP-L

• Physical Therapy Clinic/Center in Fargo, ND
• Providers in Fargo, ND by specialty
• Physical Therapy Clinic/Center in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.