NPIMap

Organization Active NPI

360 Physical Therapy

  • Physical Therapist
  • Minot, ND
National Provider Identifier
1801463013
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
360 PHYSICAL THERAPY
Practice address
400 S Broadway Ste B
Minot, ND 58701-4403
Phone
(406) 522-7488
Fax
(406) 522-7487
NPI assigned
Jun 7, 2021
Last updated
Nov 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Authorized official

Name
James Kabisch Jr.
Title
Cfo/Coo
Phone
(406) 522-7488

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU
Durable Medical Equipment & Medical Supplies 332B00000X NU

Addresses

Primary practice location

400 S Broadway Ste B
Minot, ND 58701-4403

Mailing address

PO Box 11629
Bozeman, MT 59719-1629
Phone (406) 522-7488

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL Bozeman Direct Lone Peak Physical Therapy Inc.
CONNECT URL Minot Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211027003149 ND Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8921404658 Receives reassigned benefits from 8 practitioners
Practice locations: Minot, ND

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

400 S Broadway
Ste B
Minot, ND 58701
Phone (406) 522-7488

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668729600000",
    "number": "1801463013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11629",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597191629",
            "telephone_number": "406-522-7488",
            "fax_number": "406-522-7487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S BROADWAY STE B",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014403",
            "telephone_number": "406-522-7488",
            "fax_number": "406-522-7487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360 PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-07",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A",
        "authorized_official_last_name": "KABISCH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CFO/COO",
        "authorized_official_telephone_number": "406-522-7488",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Bozeman",
            "affiliation": "Y",
            "endpointDescription": "Lone Peak Physical Therapy location",
            "affiliationName": "Lone Peak Physical Therapy Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "47 Pronghorn TRL",
            "address_2": "STE 1",
            "city": "Bozeman",
            "state": "MT",
            "country_code": "US",
            "postal_code": "597186096",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Minot",
            "affiliation": "N",
            "endpointDescription": "360 Physical Therapy",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "400 S Broadway Ste B",
            "city": "Minot",
            "state": "ND",
            "country_code": "US",
            "postal_code": "587014403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; 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.