Jaclyn Nicole Tarnowski, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1179 Issued in ND

Practice address

150 County Road 34
Arthur, ND 58006-4102

Phone

(701) 967-8316

NPI assigned

Jul 18, 2016

Last updated

Jul 18, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468800000000",
    "number": "1679926331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE STE D",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709697",
            "telephone_number": "503-570-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 COUNTY ROAD 34",
            "city": "ARTHUR",
            "state": "ND",
            "postal_code": "580064102",
            "telephone_number": "701-967-8316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARNOWSKI",
        "first_name": "JACLYN",
        "middle_name": "NICOLE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-18",
        "last_updated": "2016-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ND",
            "license": "1179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill A Berg, COTA
• Beth Bush
• Casselton Drug Inc (Arthur Drug)
• Bridgit Lehfeldt, COTA
• Nicole Oster, OTR/L
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Arthur)
• The Evangelical Lutheran Good Samaritan Society (Prairie Villa)
• Katie Elizabeth Thompson, PHARM.D
• Amy Jo Winjum, OTR/L

• Physical Therapy Assistant in Arthur, ND
• Providers in Arthur, ND by specialty
• Physical Therapy Assistant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2016; 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.