Nicole L Jefferson, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2071 Issued in ND

Practice address

3242 20TH St S
Fargo, ND 58104

Phone

(701) 893-2639

Fax

(701) 893-2638

NPI assigned

May 8, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of North Dakota School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Apex Physical Therapy and Wellness Center PCGroup PAC ID 6507926235, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Apex Physical Therapy and Wellness Center, PC

  • Physical Therapy Clinic/Center
  • West Fargo, ND
  • NPI 1417109059

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Body Works Physical Therapy, LTD.

  • Massage Therapist
  • Fargo, ND
  • NPI 1689085177
  NPD

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1578052239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3242 20TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58104",
            "telephone_number": "701-893-2639",
            "fax_number": "701-893-2638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3242 20TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58104",
            "telephone_number": "701-893-2639",
            "fax_number": "701-893-2638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "NICOLE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "ND",
            "license": "2071",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "2071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jayjay Care LLC
• Jayjay Care LLC
• JDL Counseling LLC
• Wilny Jean
• Jed D Hillmer OD PLLC
• Jason Robert Jeffress, MD
• Jeffrey D Bates LPCC PLLC
• Jeffrey J Harrie DDS PC
• Rachel Eleanor Jellison, M.S., CF-SLP
• Deborah J Jenkins, R.N.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.