Active NPI
Nichole Marie Sommers, PT, DPT, ATC
- Physical Therapist
- Bismarck, ND
National Provider Identifier
1568669398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1458
- Practice address
- 1000 W Century Ave
Bismarck, ND 58503-0913 - Phone
- (701) 355-1295
- Fax
- (701) 323-7046
- NPI assigned
- Jun 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1458 | ND | Primary |
| Athletic Trainer | 2255A2300X | 297-05 | ND |
Addresses
Primary practice location
1000 W Century Ave
Bismarck, ND 58503-0913
Mailing address
4925 Souris St
Bismarck, ND 58503-0733
Phone (701) 730-1267
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568669398 | Other | ND | TRIWEST |
| 51764 | Medicaid | ND | |
| P00436245 | Other | ND | PGA |
| 1568669398 | Other | ND | BCBS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1458 | ND | MD | Addiction (Substance Use Disorder) Counselor |
| 297-05 | ND | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Applied Medical, Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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": "1182902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284422400000",
"number": "1568669398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4925 SOURIS ST",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585030733",
"telephone_number": "701-730-1267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 W CENTURY AVE",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585030913",
"telephone_number": "701-355-1295",
"fax_number": "701-323-7046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOMMERS",
"first_name": "NICHOLE",
"middle_name": "MARIE",
"credential": "PT, DPT, ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-27",
"last_updated": "2010-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ND",
"license": "1458",
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ND",
"license": "297-05",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIWEST",
"identifier": "1568669398",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "51764",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PGA",
"identifier": "P00436245",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1568669398",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bismarck, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.