DR. JODI DENEE HENDRICKSON (NPI# 1275680720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275680720 |
Entity Type | Individual |
Full Name | DR. JODI DENEE HENDRICKSON |
Credential | PT |
Practice Address |
3060 Frontier Way Fargo ND 58104-8909 |
Mailing Address |
4272 Auburn Ave Fargo ND 58104-8428 |
Practice Telephone | 7012322340 |
Practice Fax Number | 7012322330 |
Mailing Telephone | 7018936776 |
Enumeration Date | 2007-01-05 |
Last Update Date | 2012-02-15 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
1431 | ND | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
COVENTRY | 1083461 | 01 | |
ND | 51421 | 05 | |
ND | TRICARE | A016 | 01 |
NORIDIAN BPA | 28235 | 01 | |
MEDICA/UNITED HEALTH | 64-07780 | 01 | |
HEALTH PARTNERS CIGNA | HP78396 | 01 | |
ND | BCBS ALL STATES | 28235 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841833860 | Jodi Hendrickson | Occupational Therapist | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2019-10-22 |
1073017646 | Jodi Lynn Jo Hendrickson | Behavior Technician | 925 Hwy Vv, Kennett, MO 63857 | 2018-03-20 |
Street Address |
3060 FRONTIER WAY |
City | FARGO |
State | ND |
Zip Code | 58104-8909 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548601164 | Lora Rogness | Speech-Language Pathologist | 3060 Frontier Way, Fargo, ND 58104-8909 | 2013-07-11 |
1780021097 | Barbra Matthews | Occupational Therapy Assistant | 3060 Frontier Way, Fargo, ND 58104-8909 | 2013-05-28 |
1962743690 | Sarah Rodenburg | Occupational Therapist | 3060 Frontier Way, Fargo, ND 58104-8909 | 2013-03-05 |
1720322373 | Stacy Henrich | Speech-Language Pathologist | 3060 Frontier Way, Fargo, ND 58104-8909 | 2012-11-20 |
1205100203 | Desiree Wildeman | Occupational Therapist | 3060 Frontier Way, Fargo, ND 58104-8909 | 2012-03-08 |
1215201314 | Alyssa Lynn Sauvageau | Occupational Therapist | 3060 Frontier Way, Fargo, ND 58104-8909 | 2012-03-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043837347 | Pinnacle Therapy & Wellness, Pllc | Physical Therapist | 4500 36th Ave S Suite 100, Fargo, ND 58104 | 2020-07-02 |
1619509858 | Patricia Helen Bathie | Counselor | 4243 Auburn Ave., Fargo, ND 58104 | 2020-02-05 |
1346892866 | Elizabeth Olis | Registered Nurse | 2633 55th St. S, Apartment 202, Fargo, ND 58104 | 2019-07-15 |
1780247023 | Keith Kirimi Ndege | Physical Therapy Assistant | 5225 23rd Ave South, Fargo, ND 58104 | 2019-04-22 |
1346728557 | Ms4 Pllc | Pharmacy | 4476 31st Avenue South, Suite #105, Fargo, ND 58104 | 2018-07-31 |
1891286977 | Jessica Rae Majidian | Dentist | 3030 49th St S, Fargo, ND 58104 | 2018-05-23 |
1821588500 | Alissa Nichole Larson | Pharmacist | 5675 26th Ave S St. 136a, Fargo, ND 58104 | 2018-05-17 |
1790297430 | Northern Lights Dental | Dentist | 4150 19th Ave S, Suite 301, Fargo, ND 58104 | 2017-11-03 |
1619406733 | Cobalt Rehabilitation Hospital Fargo LLC | Rehabilitation Hospital | 4671 38th Street S, Fargo, ND 58104 | 2017-06-12 |
1790210318 | Homefield Health, LLC | Clinic/Center | 4141 31st Ave S., Ste 102, Fargo, ND 58104 | 2017-04-21 |
Find all providers in zip 58104 |
Taxonomy Code | 2251P0200X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Physical Therapist |
Specialization | Pediatrics |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114198983 | Erika Lea Hanson | Physical Therapist | 1420 8th St N, Fargo, ND 58102-2613 | 2008-03-19 |
1023411386 | Theresa Marie Cowles | Physical Therapist | 801 Broadway N, Fargo, ND 58102-3641 | 2014-10-01 |
1578966057 | Adrienne Shirlene Wickenheiser | Physical Therapist | 801 Broadway N, Fargo, ND 58102-3641 | 2014-09-29 |
1427229954 | Catherine Ann Sadler-villella | Physical Therapist | 4201 25th St S, Fargo, ND 58104-6800 | 2008-03-12 |
1730369935 | Suzanne Shelley Hammer | Physical Therapist | 3060 Frontier Way S, Fargo, ND 58104-8909 | 2007-11-06 |
1922155043 | Shannon Marie Buckmier | Physical Therapist | 3001 11th St S, Fargo, ND 58103-6048 | 2007-01-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871853010 | Kim Bloms | Physical Therapist | 1702 E Main St # 103, Mandan, ND 58554-3818 | 2012-05-22 |
1861619900 | Karena Lee Holm | Physical Therapist | 2200 Library Cir, Grand Forks, ND 58201 | 2007-04-19 |
1497805196 | Great Kids Therapy, Ltd. | Physical Therapist | 102 W Beaton Dr, Suite 100, West Fargo, ND 58078-2652 | 2007-01-12 |
1053468223 | Brian Allen Borchardt | Physical Therapist | 7119 Maple Ln, Horace, ND 58047-4714 | 2007-01-03 |
1245287069 | Tammy Leigh Sayler | Physical Therapist | 2951 S 34th St, Grand Forks, ND 58201-6061 | 2006-05-27 |
1689290124 | Engagement Pllc | Physical Therapist | 508 13th St E, Dickinson, ND 58601-4179 | 2020-06-21 |
1548712516 | Jeremy St. Aubin | Physical Therapist | 612 Center Ave N, Ashley, ND 58413-7013 | 2016-10-26 |
1487032173 | Melissa Marie Lennon | Physical Therapist | 2200 Library Cir, Grand Forks, ND 58201-6326 | 2015-05-13 |
1225220759 | Jackie Mrachek | Physical Therapist | 300 N 7th St, Bismarck, ND 58501-4439 | 2007-08-17 |
1093857633 | Patricia A Gerszewski | Physical Therapist | 215 2nd St Se, Minot, ND 58701-3924 | 2007-02-12 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.