Active NPI
Alexis Jae Eissinger, PT, DPT
- Physical Therapist
- Fargo, ND
National Provider Identifier
1851130504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2679
- Practice address
- 1720 University Dr S
Fargo, ND 58103-4940 - Phone
- (701) 234-2000
- NPI assigned
- May 22, 2024
- Last updated
- May 22, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 2679 | ND | Primary |
Addresses
Primary practice location
1720 University Dr S
Fargo, ND 58103-4940
Mailing address
6017 80TH Ave S
Horace, ND 58047-5524
Phone (701) 429-0519
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 |
|---|---|---|---|
| 2679 | ND | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716336000000",
"number": "1851130504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6017 80TH AVE S",
"city": "HORACE",
"state": "ND",
"postal_code": "580475524",
"telephone_number": "701-429-0519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1720 UNIVERSITY DR S",
"city": "FARGO",
"state": "ND",
"postal_code": "581034940",
"telephone_number": "701-234-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EISSINGER",
"first_name": "ALEXIS",
"middle_name": "JAE",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-22",
"last_updated": "2024-05-22",
"certification_date": "2024-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ND",
"license": "2679",
"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 May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.