Erika Teresa Petry, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1652 Issued in ND

Practice address

2829 University Dr S Ste 202
Fargo, ND 58103-6050

Phone

(701) 478-7868

Fax

(701) 356-7005

NPI assigned

Aug 3, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Erika Teresa Moderow Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1533254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1578041273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CROSS STREET",
            "city": "BIG STONE CITY",
            "state": "SD",
            "postal_code": "57216",
            "telephone_number": "605-541-1140",
            "fax_number": "605-541-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 UNIVERSITY DR S STE 202",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036050",
            "telephone_number": "701-478-7868",
            "fax_number": "701-356-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRY",
        "first_name": "ERIKA",
        "middle_name": "TERESA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-03",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "1652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIKA",
            "last_name": "MODEROW",
            "middle_name": "TERESA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Terry A Peterson, PA-C
• Thomas Michael Peterson, ATC
• Wanda Lee Peterson, LRD
• Katherine Theresa Petrik
• Anna Petry, D.C.
• Destinee Petsinger
• Haley Marie Pettis, DPT
• Jeanine Peyerl, OTR/L
• Eric Arash Pezhman, M.D.
• Carrie Pfaff, NP

• Occupational Therapist in Fargo, ND
• Providers in Fargo, ND by specialty
• Occupational Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; 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.