Backstrom Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

1755 Issued in ND

Legal business name

BACKSTROM PHYSICAL THERAPY LLC

Practice address

215 Highway 2 SW Ste 103
Rugby, ND 58368-2407

Phone

(701) 351-0775

NPI assigned

Aug 22, 2018

Last updated

Aug 22, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jordan BackstromNPI 1376958009

Title

Physical Therapist

Phone

(701) 351-0775

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jordan Backstrom

  • Physical Therapist
  • Rugby, ND
  • NPI 1376958009
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534896000000",
    "number": "1639650393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 HIGHWAY 2 SW STE 103",
            "city": "RUGBY",
            "state": "ND",
            "postal_code": "583682407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 HIGHWAY 2 SW STE 103",
            "city": "RUGBY",
            "state": "ND",
            "postal_code": "583682407",
            "telephone_number": "701-351-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACKSTROM PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-22",
        "last_updated": "2018-08-22",
        "status": "A",
        "authorized_official_last_name": "BACKSTROM",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "701-351-0775"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "ND",
            "license": "1755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1987654321",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen A Alme, FNP
• Altru Health System (Heart of America Medical Center)
• Jill Marie Armstrong, PHARMACY TECH
• Rose Marie Armstrong
• Jordan Backstrom
• Beloved Hope Care Incorporated
• Carol A Berg, FNP
• Nichole Block, D.C.
• Teresa Ann Block, CRNA

• Physical Therapy Clinic/Center in Rugby, ND
• Providers in Rugby, ND by specialty
• Physical Therapy Clinic/Center in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.