Kyle Orville Schmidt

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

996-3-1-19A Issued in ND

Practice address

1201 25TH St S
Fargo, ND 58103-2311

Phone

(701) 451-4900

Fax

(651) 925-0057

NPI assigned

Aug 23, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 10, 2024 through Apr 10, 2028

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Valley Christian Counseling Center Inc

  • Professional Counselor
  • Fargo, ND
  • NPI 1467559427
  NPD (past)

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

{
    "created_epoch": "1377216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1700210010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2624 9TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032350",
            "telephone_number": "701-298-4500",
            "fax_number": "701-298-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 25TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032311",
            "telephone_number": "701-451-4900",
            "fax_number": "651-925-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "KYLE",
        "middle_name": "ORVILLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-23",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "996-3-1-19A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey J Schmidt, PT
• Josie Schmidt
• Kari Schmidt, PT, DPT
• Katie Marie Schmidt, LMSW
• Kristi Marie Schmidt, PHARMD
• Lindsey Schmidt, LGSW, LMSW
• Lori Schmidt, FNP
• Madeline Schmidt, SLP
• McKenzy Schmidt
• Nicholas Schmidt

• Professional Counselor in Fargo, ND
• Providers in Fargo, ND by specialty
• Professional Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.