Individual provider Active NPI

Shaunna Messmer-Lavalley, PT, DPT

  • Physical Therapist
  • Fargo, ND
National Provider Identifier
1952946444
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4450 31St Ave S Ste 104
Fargo, ND 58104-4557
Phone
(701) 451-9417
NPI assigned
Nov 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

4450 31St Ave S Ste 104
Fargo, ND 58104-4557

Mailing address

4450 31St Ave S Ste 104
Fargo, ND 58104-4557
Phone (701) 451-9417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200424000179 ND Practitioner - Physical Therapist in Private Practice 9830529320 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caring Edge Op LLCGroup PAC ID 6406114131, 36 clinicians

Practice addresses (Care Compare)

3406 Dominion St
Bismarck, ND 58503-5577
Phone (701) 258-7489

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Rehabilitation Center Inc Physical Therapist CurrentSince Mar 1, 2020 Accepting new patients
Professional Rehabilitation Center Inc Physical Therapist CurrentSince Mar 1, 2020 Accepting new patients
Caring Edge Op LLC Physical Therapist CurrentSince Apr 19, 2021 Accepting new patients
Horizon Therapy, Inc. Physical Therapist PastSince Jun 14, 2020 Accepting new patients

Locations

4450 31st Ave S
Ste 104
Fargo, ND 58104
Phone (701) 451-9417

1200 Harwood Dr S
Fargo, ND 58104
Phone (701) 451-4811

2801 39th Ave SE
Mandan, ND 58554
Phone (701) 663-5664

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1952946444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 31ST AVE S STE 104",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044557",
            "telephone_number": "701-451-9417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 31ST AVE S STE 104",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044557",
            "telephone_number": "701-451-9417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESSMER-LAVALLEY",
        "first_name": "SHAUNNA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-08",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "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 Nov 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.