Keith Kirimi Ndege
Individual provider Active NPI Physical Therapy Assistant · Fargo, ND
NPI 1780247023 · NPPES record last updated Apr 22, 2019
Key facts
- NPI
- 1780247023
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- PTA.0014512 (CO)
- Practice address
- 5225 23Rd Ave South
Fargo, ND 58104 - Phone
- (701) 417-3400
- NPI assigned
- Apr 22, 2019
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA.0014512 | CO | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA.0014512 | CO | Yes |
Addresses
Primary practice location
5225 23Rd Ave South
Fargo, ND 58104
Mailing address
5357 27TH St South, Apt 110
Fargo, ND 58104
Phone (701) 781-7573
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- Jeanne Ndayishimiye
- Nwachan I Ndi
- Anesia Nahimana Ndikubwimana
- Marcus James Neadeau Sr.
- Kaitlan Elizabeth Neard
- Patricia Neidviecky
All providers in Fargo, ND · Physical Therapy Assistant in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.