Active NPI
Jeanine Peyerl, OTR/L
- Occupational Therapist
- Fargo, ND
National Provider Identifier
1700056488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 648
- Practice address
- 1701 4TH Ave South
Jefferson Elementary
Fargo, ND 58103-1562 - Phone
- (701) 446-4700
- Fax
- (701) 446-4799
- NPI assigned
- Mar 10, 2008
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 648 | ND | Primary |
Addresses
Primary practice location
1701 4TH Ave South
Jefferson Elementary
Fargo, ND 58103-1562
Mailing address
1701 4TH Ave South
Jefferson Elementary
Fargo, ND 58103
Phone (701) 446-4700
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 648 | ND | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528416000000",
"number": "1700056488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 4TH AVE SOUTH",
"address_2": "JEFFERSON ELEMENTARY",
"city": "FARGO",
"state": "ND",
"postal_code": "58103",
"telephone_number": "701-446-4700",
"fax_number": "701-446-4799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 4TH AVE SOUTH",
"address_2": "JEFFERSON ELEMENTARY",
"city": "FARGO",
"state": "ND",
"postal_code": "581031562",
"telephone_number": "701-446-4700",
"fax_number": "701-446-4799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEYERL",
"first_name": "JEANINE",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-10",
"last_updated": "2018-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ND",
"license": "648",
"primary": true
}
],
"identifiers": [],
"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 Jun 8, 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.