Active NPI
Evan Martell, DPT
- Physical Therapist
- Fargo, ND
National Provider Identifier
1831647668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1991
- Practice address
- 736 Broadway N
Fargo, ND 58102-4421 - Phone
- (701) 234-2000
- NPI assigned
- Sep 21, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1991 | ND | Primary |
Addresses
Primary practice location
736 Broadway N
Fargo, ND 58102-4421
Mailing address
5851 58TH Ave S
Fargo, ND 58104-5705
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1991 | ND | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474416000000",
"number": "1831647668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5851 58TH AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "581045705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "736 BROADWAY N",
"city": "FARGO",
"state": "ND",
"postal_code": "581024421",
"telephone_number": "701-234-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTELL",
"first_name": "EVAN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-21",
"last_updated": "2016-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ND",
"license": "1991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.