Individual provider Active NPI

Stephani G Bertsch, DPT

  • Physical Therapist
  • Rolla, ND
National Provider Identifier
1619195237
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1101 Issued in ND
Practice address
213 2ND Ave NE
Rolla, ND 58367-0759
Phone
(701) 477-3161
Fax
(701) 477-5564
NPI assigned
Apr 20, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1101 ND Primary

Addresses

Primary practice location

213 2ND Ave NE
Rolla, ND 58367-0759

Mailing address

213 2ND Ave NE
PO Box 759
Rolla, ND 58367-0759
Phone (701) 477-3161

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

LicenseStateTypeSpecialty
1101NDMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619195237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 2ND AVE NE",
            "address_2": "PO BOX 759",
            "city": "ROLLA",
            "state": "ND",
            "postal_code": "583670759",
            "telephone_number": "701-477-3161",
            "fax_number": "701-477-5564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 2ND AVE NE",
            "city": "ROLLA",
            "state": "ND",
            "postal_code": "583670759",
            "telephone_number": "701-477-3161",
            "fax_number": "701-477-5564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTSCH",
        "first_name": "STEPHANI",
        "middle_name": "G",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "1101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolla, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.