Active NPI
Stephanie M Petrauskis, PT, DPT
- Physical Therapist
- Minot, ND
National Provider Identifier
1972921633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1909
- Practice address
- 1 Burdick Expy W
Minot, ND 58701-4406 - Phone
- (701) 857-5000
- NPI assigned
- Mar 31, 2014
- Sex
- Female
- 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 | 1909 | ND | Primary |
Addresses
Primary practice location
1 Burdick Expy W
Minot, ND 58701-4406
Mailing address
1 Burdick Expy W
Minot, ND 58701-4406
Phone (701) 857-5000
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1909 | ND | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Performance Physical Therapy PLLC | Physical Therapist | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Minot, ND
- NPI 1407707219
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470873600000",
"number": "1972921633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 BURDICK EXPY W",
"city": "MINOT",
"state": "ND",
"postal_code": "587014406",
"telephone_number": "701-857-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BURDICK EXPY W",
"city": "MINOT",
"state": "ND",
"postal_code": "587014406",
"telephone_number": "701-857-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRAUSKIS",
"first_name": "STEPHANIE",
"middle_name": "M",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-31",
"last_updated": "2016-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ND",
"license": "1909",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minot, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.