Active NPI
Chris Roberts Fosness
- Physical Therapist
- Mitchell, SD
National Provider Identifier
1912271990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0392
- Practice address
- 501 W Havens Ave
Suite 103
Mitchell, SD 57301-4366 - Phone
- (605) 995-6044
- Fax
- (605) 995-6044
- NPI assigned
- Mar 8, 2012
- 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 | 0392 | SD | Primary |
Addresses
Primary practice location
501 W Havens Ave
Suite 103
Mitchell, SD 57301-4366
Mailing address
720 E 6TH Ave
Mitchell, SD 57301-2814
Phone (605) 995-6044
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 |
|---|---|---|---|
| 0392 | SD | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478476800000",
"number": "1912271990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 E 6TH AVE",
"city": "MITCHELL",
"state": "SD",
"postal_code": "573012814",
"telephone_number": "605-995-6044",
"fax_number": "605-995-6044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 W HAVENS AVE",
"address_2": "SUITE 103",
"city": "MITCHELL",
"state": "SD",
"postal_code": "573014366",
"telephone_number": "605-995-6044",
"fax_number": "605-995-6044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOSNESS",
"first_name": "CHRIS",
"middle_name": "ROBERTS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-03-08",
"last_updated": "2016-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SD",
"license": "0392",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mitchell, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.