Active NPI
Jason Allen Burud, P.T.,D.P.T.
- Sports Physical Therapist
- Fargo, ND
National Provider Identifier
1912112814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physical Therapist
- License
- 952
- Practice address
- 2400 32ND Ave S
Fargo, ND 58103-5800 - Phone
- (701) 234-8700
- NPI assigned
- May 14, 2007
- 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 |
|---|---|---|---|---|
| Sports Physical Therapist | 2251S0007X | 952 | ND | Primary |
Addresses
Primary practice location
2400 32ND Ave S
Fargo, ND 58103-5800
Mailing address
1609 29TH Ave S
Fargo, ND 58103-5922
Phone (701) 241-8516
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 |
|---|---|---|---|
| 952 | ND | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220832000000",
"number": "1912112814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1609 29TH AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "581035922",
"telephone_number": "701-241-8516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 32ND AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "581035800",
"telephone_number": "701-234-8700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURUD",
"first_name": "JASON",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "P.T.,D.P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-14",
"last_updated": "2008-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "ND",
"license": "952",
"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 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.