Individual provider Active NPI

Suzanne Sobolik, PT

  • Physical Therapist
  • Dickinson, ND
National Provider Identifier
1699867580
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1377 Issued in ND
Practice address
683 State Ave Ste B
Dickinson, ND 58601-4660
Phone
(701) 483-9400
Fax
(701) 483-9398
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1377 ND Primary

Addresses

Primary practice location

683 State Ave Ste B
Dickinson, ND 58601-4660

Mailing address

683 State Ave Ste B
Dickinson, ND 58601-4660
Phone (701) 483-9400

Other identifiers 2

IdentifierTypeStateIssuer
50949MedicaidND
26225OtherNDBLUE CROSS

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

LicenseStateTypeSpecialty
1377NDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Omaha Therapy Dba Rehab Visions Physical Therapist Past Accepting new patients
Omaha Therapy, Inc Past Accepting new patients

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699867580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "683 STATE AVE STE B",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586014660",
            "telephone_number": "701-483-9400",
            "fax_number": "701-483-9398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "683 STATE AVE STE B",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586014660",
            "telephone_number": "701-483-9400",
            "fax_number": "701-483-9398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBOLIK",
        "first_name": "SUZANNE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "1377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50949",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "26225",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickinson, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.