COUNTRYSIDE PHYSICAL THERAPY, PLLC (NPI# 1487127825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487127825 |
| Entity Type | Organization |
| Organization Name | COUNTRYSIDE PHYSICAL THERAPY, PLLC |
| Other Organization Name | COUNTRYSIDE PHYSICAL THERAPY |
| Practice Address |
42 Central Ave S Killdeer ND 58640-4000 |
| Mailing Address |
Po Box 993 Killdeer ND 58640-0993 |
| Practice Telephone | 6053904326 |
| Mailing Telephone | 6053904326 |
| Enumeration Date | 2019-01-08 |
| Last Update Date | 2019-12-19 |
| Authorized Official Name | TYLEA BERGMAN (OWNER) |
| Authorized Official Telephone | 6053904326 |
| Authorized Official Credential | DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Countryside Physical Therapy | Doing Business As Name - Organization |
| Street Address |
42 CENTRAL AVE S |
| City | KILLDEER |
| State | ND |
| Zip Code | 58640-4000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487042438 | Killdeer Chiropractic Acupuncture & Bodywork | Chiropractor | 42 Central Ave S, Killdeer, ND 58640-4000 | 2014-12-29 |
| 1942789425 | Tylea Bergman | Physical Therapist | 42 Central Ave S, Killdeer, ND 58640-4000 | 2018-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245628684 | Dunn County Social Services | Case Management | 125 Central Ave North, Killdeer, ND 58640 | 2015-01-08 |
| 1447336466 | Lindsey Ann Hysjulien | Occupational Therapist | 95 Hilltop Dr, Killdeer, ND 58640 | 2006-10-31 |
| 1508972936 | Killdeer Pharmacy Inc. | Pharmacy | 14 South Central Ave, Killdeer, ND 58640 | 2006-08-21 |
| 1114099033 | Stephanie Marie Aafedt | Occupational Therapist | 95 Hilltop Dr, Killdeer, ND 58640 | 2006-11-15 |
| 1952322380 | Suzanne Kostenko | Nurse Practitioner | 150 Central Ave N, Killdeer, ND 58640 | 2006-07-21 |
| 1316967615 | Lori A Jepson | Nurse Practitioner | 150 Central Ave N, Killdeer, ND 58640 | 2006-07-20 |
| 1851311146 | Janis Neumann | Nurse Practitioner | 150 Central Ave N, Killdeer, ND 58640 | 2006-07-20 |
| 1922121276 | Killdeer Area Ambulance Service | Ambulance | 151 Central Avenue North, Killdeer, ND 58640-0033 | 2007-04-09 |
| 1184641110 | St Joseph's Hospital and Health Center | Clinic/Center | 150 Central Ave N, Killdeer, ND 58640-0668 | 2006-07-16 |
| 1922124833 | Jody A. Doe | Pharmacist | 14 South Central Ave, Killdeer, ND 58640-0745 | 2007-03-22 |
| Find all providers in zip 58640 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417139882 | Hill Top Home of Comfort | Clinic/Center | 95 Hill Top Dr, Killdeer, ND 58640-0780 | 2007-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659996924 | Encompass Therapy LLC | Clinic/Center | 600 2nd Ave N, Hettinger, ND 58639-7448 | 2020-06-12 |
| 1477112027 | Run Your Life LLC | Clinic/Center | 1751 36th Ave S Apt 105, Grand Forks, ND 58201-7347 | 2019-06-07 |
| 1497216246 | Elevate Physical Therapy and Performance, LLC | Clinic/Center | 3935 Dakota Dr, Grand Forks, ND 58201-3544 | 2019-03-26 |
| 1639650393 | Backstrom Physical Therapy LLC | Clinic/Center | 215 Highway 2 Sw Ste 103, Rugby, ND 58368-2407 | 2018-08-22 |
| 1144666934 | Rehab Visions | Clinic/Center | 2710 Chokecherry St, Williston, ND 58801-2926 | 2013-05-20 |
| 1225289341 | Jones Physical Therapy | Clinic/Center | 1415 Border Ln, Washburn, ND 58577-4153 | 2008-10-07 |
| 1275542268 | Southeast Therapy Services Inc | Clinic/Center | 100 1st Avenue Southwest, Omega City Plaza, Lamoure, ND 58458-0686 | 2006-08-07 |
| 1447200373 | Dsj Enterprises, LLC | Clinic/Center | 2945 N 11th St, Bismarck, ND 58503-0514 | 2006-05-11 |
| 1285194324 | Living Life Physical Therapy | Clinic/Center | 2311 Elk Dr, Minot, ND 58701-5633 | 2019-03-24 |
| 1649736422 | Kids In Motion Inc | Clinic/Center | 1702 E Main St # 103, Mandan, ND 58554-3818 | 2019-02-16 |
| Find all providers with the same taxonomy | ||||
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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.