Nicole Marie Folston, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1269A Issued in ND

Practice address

1461 Broadway N
Fargo, ND 58102-2622

Phone

(701) 293-6037

Fax

(701) 293-0242

NPI assigned

Oct 30, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Total Balance Dietitian, LLC

  • Registered Dietitian
  • Fargo, ND
  • NPI 1255190534
  NPD (past)
• Total Balance Physical Therapy and Fitness, LLC

  • Physical Therapist
  • Fargo, ND
  • NPI 1588175061
  NPD (past)

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1740757541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1461 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581022622",
            "telephone_number": "701-293-6037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1461 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581022622",
            "telephone_number": "701-293-6037",
            "fax_number": "701-293-0242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4041 Main Ave",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581031145",
            "country_code": "US",
            "telephone_number": "701-293-6037",
            "fax_number": "701-293-0242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOLSTON",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-30",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ND",
            "license": "1269A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH DAKOTA BOARD OF PHYSICAL THERAPY",
            "identifier": "1269A",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy M Foldesi-Penas, MSW
• Emily Folk, CASE MANAGER
• Rhianna Kay Folk, RBT
• Bailey Folkers
• Erin Marie Follman, MD
• Cathy Denies Fonder, APRN, FNP-C
• Germaine Essangui Fongang
• Alex Fontaine, DPT
• Taylor Fontaine, PA-C
• Valerie Foran

• Physical Therapy Assistant in Fargo, ND
• Providers in Fargo, 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 Oct 30, 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.