Individual provider Active NPI

Laura Beth Marquardt, DPT

  • Physical Therapist
  • Fargo, ND
National Provider Identifier
1629557624
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-1997 Issued in ND
Practice address
4420 37TH Ave S
Fargo, ND 58104-3400
Phone
(701) 365-4771
Fax
(701) 365-8134
NPI assigned
Aug 9, 2018
Last updated
Aug 9, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2018

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 PT-1997 ND Primary

Addresses

Primary practice location

4420 37TH Ave S
Fargo, ND 58104-3400

Mailing address

2965 E Tarpon Dr Ste 150
Meridian, ID 83642-9007
Phone (701) 365-4771

Other identifiers 1

IdentifierTypeStateIssuer
PT-1997OtherNDSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181002002064 ND Practitioner - Physical Therapist in Private Practice 3870845878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caring Edge Op LLCGroup PAC ID 6406114131, 36 clinicians

Practice addresses (Care Compare)

800 16TH Ave SE
Minot, ND 58701-6781
Phone (701) 852-1399

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-1997NDMDPhysical Therapist
1997NDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Caring Edge Op LLC Physical Therapist CurrentSince Aug 10, 2018 Accepting new patients

Locations

2965 E Tarpon Dr
Ste 150
Meridian, ID 83642
Phone 2082879420110

2801 39th Ave SE
Mandan, ND 58554
Phone (701) 663-5664

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1629557624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2965 E TARPON DR STE 150",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429007",
            "telephone_number": "701-365-4771",
            "fax_number": "701-365-8134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 37TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581043400",
            "telephone_number": "701-365-4771",
            "fax_number": "701-365-8134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUARDT",
        "first_name": "LAURA",
        "middle_name": "BETH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-09",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "PT-1997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PT-1997",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; 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.