Ivy L Jordan, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2065 Issued in ND

Practice address

736 Broadway N
Fargo, ND 58102

Phone

(701) 234-2000

NPI assigned

Nov 30, 2011

Last updated

Aug 19, 2018By 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 4

Addresses

Other names 1

• Ivy L Roe Former name

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": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534636800000",
    "number": "1689941999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155 BLUESTEM DR",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580788002",
            "telephone_number": "701-353-5476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58102",
            "telephone_number": "701-234-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "IVY",
        "middle_name": "L",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-30",
        "last_updated": "2018-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": "PT871270",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11224",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305206961",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "2065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IVY",
            "last_name": "ROE",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marlys Kay Joramo
• Renee Jordahl
• Andrew A Jordan, MD
• Cody Jordan
• Elizabeth Rose Jordan, DC
• Sarah Jordan
• Erin Jore
• Jorgensen Chiropractic, PC (Red River Wellness)
• Jennifer Jorgensen, CRNA
• Kortney Joy Jorgensen, LPN

• Physical Therapist in Fargo, ND
• Providers in Fargo, ND by specialty
• Physical Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2018; 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.