Active NPI
Lynn Marie Boettcher Fjellanger, ED.D, P.T.
- Physical Therapist
- Sioux Falls, SD
National Provider Identifier
1679765655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0305
- Practice address
- 1500 W 38TH St
Sioux Falls, SD 57105 - Phone
- (605) 336-1997
- NPI assigned
- Aug 14, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 0305 | SD | Primary |
Addresses
Primary practice location
1500 W 38TH St
Sioux Falls, SD 57105
Mailing address
1500 W 38TH St
Sioux Falls, SD 57105
Phone (605) 336-1997
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0305 | SD | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187049600000",
"number": "1679765655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 W 38TH ST",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "57105",
"telephone_number": "605-336-1997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 W 38TH ST",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "57105",
"telephone_number": "605-336-1997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOETTCHER FJELLANGER",
"first_name": "LYNN",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "ED.D, P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-14",
"last_updated": "2007-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SD",
"license": "0305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sioux Falls, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.