Suzanne R Sandsmark, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

538 Issued in ND

Practice address

3838 12TH Ave N
Fargo, ND 58102-2931

Phone

(701) 234-4700

Fax

(701) 234-4757

NPI assigned

Jul 12, 2006

Last updated

Nov 9, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Suzanne R Johnson Former name

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sanford Bismarck

  dba Family Wellness

  • Multi-Specialty Clinic/Center
  • Bismarck, ND
  • NPI 1811941172
  Medicare reassignment

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1952336265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 12TH AVE N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581022931",
            "telephone_number": "701-234-4700",
            "fax_number": "701-234-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDSMARK",
        "first_name": "SUZANNE",
        "middle_name": "R",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "2824",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52081",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "313645100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "JOHNSON",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jenna Sandman, APRN, CNP
• Lucas Sandman, D.D.S.
• Kevin Sandness, COTA/L
• Sando's Care Corporation (Home Instead Senior Care)
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• Sanford Clinic North (Sanford Neuroscience Clinic)
• Sanford Clinic North (Sanford Children's Southwest Clinic)
• Sanford Clinic North (Sanford Pharmacy Broadway 340B)
• Sanford Clinic North (Sanford Professional Building)

• Physical Therapist in Fargo, ND
• Providers in Fargo, ND by specialty
• Physical Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.