Alexis Jade Johnsrud, MSOTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1468 Issued in ND

Practice address

200 8TH St NE
Watford City, ND 58854-7532

Phone

(701) 842-6307

NPI assigned

Apr 6, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1932563855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 8TH ST NE",
            "city": "WATFORD CITY",
            "state": "ND",
            "postal_code": "588547532",
            "telephone_number": "701-842-6307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 8TH ST NE",
            "city": "WATFORD CITY",
            "state": "ND",
            "postal_code": "588547532",
            "telephone_number": "701-842-6307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSRUD",
        "first_name": "ALEXIS",
        "middle_name": "JADE",
        "credential": "MSOTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-06",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "1468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Watford City, ND
• Providers in Watford City, ND by specialty
• Occupational Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.

Verify at the official NPI Registry.