Individual provider Active NPI

Bridget Ann Juhnke, PT, DPT

  • Physical Therapist
  • Fargo, ND
National Provider Identifier
1649745159
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2167 Issued in ND
Practice address
4450 31St Ave S Ste 104
Fargo, ND 58104-4557
Phone
(701) 451-9417
NPI assigned
Oct 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11326 MN
Physical Therapist 225100000X 2167 ND Primary

Addresses

Primary practice location

4450 31St Ave S Ste 104
Fargo, ND 58104-4557

Mailing address

3101 49TH St S Apt 105
Fargo, ND 58104-4528
Phone (320) 522-2262

Other identifiers 2

IdentifierTypeStateIssuer
2167OtherNDPHYSICAL THERAPY LICENSE
11326OtherMNMN STATE PHYSICAL THERAPY LICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210907002246 ND Practitioner - Physical Therapist in Private Practice 4284030867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Rehabilitation Center IncGroup PAC ID 5193784080, 12 clinicians

Practice addresses (Care Compare)

4450 31St Ave S
Suite 104
Fargo, ND 58104-4557
Phone (701) 451-9417

Merit-based Incentive Payment System (MIPS)

Final score
90.38 of 100Reported as group
Quality
89.93
Improvement activities
40
Cost
81.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2167NDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Rehabilitation Center Inc Physical Therapist CurrentSince Aug 16, 2021 Accepting new patients
Professional Rehabilitation Center Inc Physical Therapist CurrentSince Aug 16, 2021 Accepting new patients

Locations

4450 31st Ave S
Ste 104
Fargo, ND 58104
Phone (701) 451-9417

1200 Harwood Dr S
Fargo, ND 58104
Phone (701) 451-4811

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1649745159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 49TH ST S APT 105",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044528",
            "telephone_number": "320-522-2262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 31ST AVE S STE 104",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044557",
            "telephone_number": "701-451-9417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUHNKE",
        "first_name": "BRIDGET",
        "middle_name": "ANN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-11",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11326",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "2167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "2167",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN STATE PHYSICAL THERAPY LICENSE NUMBER",
            "identifier": "11326",
            "state": "MN"
        }
    ],
    "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 Jan 4, 2022; 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.