MRS. ADRIENNE SHIRLENE WICKENHEISER (NPI# 1578966057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578966057 |
| Entity Type | Individual |
| Full Name | MRS. ADRIENNE SHIRLENE WICKENHEISER |
| Credential | DPT |
| Practice Address |
801 Broadway N Fargo ND 58102-3641 |
| Practice Telephone | 7012345799 |
| Practice Fax Number | 7012347451 |
| Mailing Telephone | 7012345799 |
| Mailing Fax Number | 7012347451 |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2014-09-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
1838 | ND | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
801 BROADWAY N |
| City | FARGO |
| State | ND |
| Zip Code | 58102-3641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528062924 | Mark F Fisher | Radiology | 801 Broadway N, Fargo, ND 58102-3641 | 2005-06-13 |
| 1942809652 | Morgan Margaret Borud | Nurse Practitioner | 801 Broadway N, Fargo, ND 58102-3641 | 2020-10-22 |
| 1790392462 | Katie Thielges | Nurse Practitioner | 801 Broadway N, Fargo, ND 58102-3641 | 2020-09-28 |
| 1063022432 | Lindsey Schmidt | Genetic Counselor, MS | 801 Broadway N, Fargo, ND 58102-3641 | 2020-07-31 |
| 1336766161 | Yesha Shukla | Family Medicine | 801 Broadway N, Fargo, ND 58102-3641 | 2020-06-27 |
| 1891310850 | Samantha Mimi Chang | Family Medicine | 801 Broadway N, Fargo, ND 58102-3641 | 2020-06-15 |
| 1528683224 | Briana Lee Gebert-oberle | Student in an Organized Health Care Education/Training Program | 801 Broadway N, Fargo, ND 58102-3641 | 2020-06-09 |
| 1689296931 | Jillian Virginia Schommer | Student in an Organized Health Care Education/Training Program | 801 Broadway N, Fargo, ND 58102-3641 | 2020-05-09 |
| 1194344036 | Sarah Rose Carpenter | Genetic Counselor, MS | 801 Broadway N, Fargo, ND 58102-3641 | 2020-04-10 |
| 1346871258 | Randall Hagemeister | Nurse Anesthetist, Certified Registered | 801 Broadway N, Fargo, ND 58102-3641 | 2020-01-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285924 | Shelley Dene Townsend-hansen | Dentist | 1017 Broadway N, Fargo, ND 58102 | 2020-11-04 |
| 1275190779 | Anthony Joseph Duncan | Student in an Organized Health Care Education/Training Program | 1919 Elm Streent North, Fargo, ND 58102 | 2019-05-21 |
| 1003472317 | Sadie Marie Nelson | Nurse Practitioner | Sanford Broadway Clinic, 801 North Broadway, Fargo, ND 58102 | 2019-05-13 |
| 1124523576 | Christopher Peroutka | Specialist/Technologist | 1300 17th Ave N, Fargo, ND 58102 | 2018-03-28 |
| 1205331873 | Nathan Koens | Specialist/Technologist | 1300 17th Avenue North, Fargo, ND 58102 | 2018-03-27 |
| 1376063370 | Abby Nicole Fredrickson | Student in an Organized Health Care Education/Training Program | 1919 Elm Street North, Fargo, ND 58102 | 2017-06-21 |
| 1780118331 | Stephanie Melquist | Internal Medicine | Internal Medicine Resident Clinic, 801 N Broadway, Fargo, ND 58102 | 2017-04-19 |
| 1104215623 | Justin Lervik | Social Worker | 211 Elm St. N, 122, Fargo, ND 58102 | 2015-01-21 |
| 1770919441 | Courtney Ann Simanski | Speech-Language Pathologist | 415 4th St. N., Fargo, ND 58102 | 2013-09-25 |
| 1821431206 | Lanell Staroba | Pharmacist | 706 D 38th St, Fargo, ND 58102 | 2013-04-16 |
| Find all providers in zip 58102 | ||||
| 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 |
| 1275680720 | Jodi Denee Hendrickson | Physical Therapist | 3060 Frontier Way, Fargo, ND 58104-8909 | 2007-01-05 |
| 1023411386 | Theresa Marie Cowles | Physical Therapist | 801 Broadway N, Fargo, ND 58102-3641 | 2014-10-01 |
| 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.