MISS SAMANTHA JO SPAETH (NPI# 1720637630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720637630 |
| Entity Type | Individual |
| Full Name | MISS SAMANTHA JO SPAETH |
| Credential | PT, DPT |
| Practice Address |
1461 Broadway N Fargo ND 58102-2622 |
| Practice Telephone | 7012936037 |
| Practice Fax Number | 7012930242 |
| Mailing Telephone | 7012936037 |
| Mailing Fax Number | 7012930242 |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2019-09-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
2392 | ND | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2600 52nd Ave S, Fargo, ND 581047172 | 7013612280 | 7012930242 |
| 4041 Main Ave, Fargo, ND 581031145 | 7012936037 | 7012930242 |
| Street Address |
1461 BROADWAY N |
| City | FARGO |
| State | ND |
| Zip Code | 58102-2622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740757541 | Nicole Marie Folston | Physical Therapy Assistant | 1461 Broadway N, Fargo, ND 58102-2622 | 2018-10-30 |
| 1780228783 | Kyah F Armitage | Dietitian, Registered | 1461 Broadway N, Fargo, ND 58102-2622 | 2019-11-01 |
| 1437718053 | Casey Robert Sailer | Physical Therapist | 1461 Broadway N, Fargo, ND 58102-2622 | 2019-06-07 |
| 1942866553 | Bailey Rose Plutowski | Dietitian, Registered | 1461 Broadway N, Fargo, ND 58102-2622 | 2019-05-20 |
| 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 | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588175061 | Total Balance Physical Therapy and Fitness, LLC | Physical Therapist | 1461 Broadway N Ste 106, Fargo, ND 58102-2622 | 2017-10-23 |
| 1841693579 | Shayne Marc Spokely | Physical Therapist | 736 Broadway N, Fargo, ND 58102-4421 | 2014-10-08 |
| 1821491614 | Scott Brown | Physical Therapist | 2990 Seter Pkwy S, Fargo, ND 58104-8692 | 2014-10-07 |
| 1558764365 | Mark Brenner | Physical Therapist | 736 Broadway, Physical Therapy, Fargo, ND 58102-1031 | 2014-10-07 |
| 1942603279 | Brian Alan Skjerseth | Physical Therapist | 736 Broadway N, Fargo, ND 58102-4421 | 2014-10-01 |
| 1083017370 | Jennifer Lynn Lamp | Physical Therapist | 736 Broadway N, Fargo, ND 58102-4421 | 2014-10-01 |
| 1780087015 | Greg Grenz | Physical Therapist | 736 Broadway N, Fargo, ND 58102-4421 | 2014-10-01 |
| 1669875092 | James Henry Clapp | Physical Therapist | 736 Broadway N, Fargo, ND 58102-4421 | 2014-09-30 |
| 1275936809 | Karen Olson | Physical Therapist | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2014-09-26 |
| 1700094018 | Scott Brendan Nice | Physical Therapist | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2007-05-18 |
| Find all providers in FARGO | ||||
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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.