Individual provider Active NPI

Nancy K Lacina, PT

  • Physical Therapist
  • Grand Forks, ND
National Provider Identifier
1770702078
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6428 Issued in MN
Practice address
1200 S Columbia Rd
Grand Forks, ND 58201-4036
Phone
(701) 780-5000
NPI assigned
Apr 25, 2007
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 6428 MN Primary

Addresses

Primary practice location

1200 S Columbia Rd
Grand Forks, ND 58201-4036

Mailing address

PO Box 6002
Grand Forks, ND 58206-6002
Phone (701) 780-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150514000070 MN Practitioner - Physical Therapist in Private Practice 5395065460 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6428MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Altru Health System CurrentSince Mar 1, 2015 Accepting new patients
Altru Health System Current Accepting new patients
Altru Health System CurrentSince Mar 1, 2015 Accepting new patients
Clinic Pharmacy Inc Past Accepting new patients

Locations

400 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9100

607 Demers Ave
East Grand Forks, MN 56721
Phone (218) 773-0357

19120 200th St
Greenbush, MN 56726
Phone (218) 782-2400

711 Delmore Dr
Roseau, MN 56751
Phone (218) 463-1365

2355 Highway 36 W
Ste 100
Saint Paul, MN 55113
Phone (651) 292-0000

412 Main Ave NE
Warroad, MN 56763
Phone (218) 386-2020

201 E 3rd Ave S
Cavalier, ND 58220
Phone (701) 265-8338

1001 7th St NE
Devils Lake, ND 58301
Phone (701) 662-2157

1200 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5243

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

Organizations & group practices 4

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": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770702078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6002",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582066002",
            "telephone_number": "701-780-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S COLUMBIA RD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014036",
            "telephone_number": "701-780-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACINA",
        "first_name": "NANCY",
        "middle_name": "K",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "6428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.