| Great Kids Therapy, Ltd | |
|
3120 25th St S Ste N, Fargo, ND 58103-6110 | |
| (701) 205-4194 | |
| (701) 540-9044 |
| Full Name | Great Kids Therapy, Ltd |
|---|---|
| Type | Facility |
| Speciality | Occupational Therapist |
| Location | 3120 25th St S Ste N, Fargo, North Dakota |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558743013 | NPI | - | NPPES |
| 54371 | Medicaid | ND | |
| 54375 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 103207 (Minnesota) | Secondary |
| 225X00000X | Occupational Therapist | 345 (North Dakota) | Primary |
| Provider Name | Anna H Dyk |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760899082 PECOS PAC ID: 9234406901 Enrollment ID: I20170531000659 |
| Provider Name | Amanda J Nordby |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1497158026 PECOS PAC ID: 0547519761 Enrollment ID: I20180822000610 |
| Provider Name | Kari M Schiller |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1023211695 PECOS PAC ID: 9335490887 Enrollment ID: I20180921000650 |
| Provider Name | Melissa Lynn Niemi |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1831593052 PECOS PAC ID: 6507107000 Enrollment ID: I20190410002196 |
| Provider Name | Kelsey J Kopp |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1962843177 PECOS PAC ID: 8921381930 Enrollment ID: I20200309000645 |
| Provider Name | Madisyn Rolfson |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1386252377 PECOS PAC ID: 5092133744 Enrollment ID: I20200914001032 |
| Provider Name | Sydney N Johnson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1801515937 PECOS PAC ID: 2163808809 Enrollment ID: I20221003002060 |
| Provider Name | Nicole Brower |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1770107054 PECOS PAC ID: 8325424872 Enrollment ID: I20221006000963 |
| Provider Name | Lora M Rogness |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1548601164 PECOS PAC ID: 6507234481 Enrollment ID: I20221128000632 |
| Provider Name | Cassandra Wald |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1801225685 PECOS PAC ID: 0749650349 Enrollment ID: I20230321002521 |
| Provider Name | Megan Kristine Boucher |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1952926396 PECOS PAC ID: 2668846064 Enrollment ID: I20230327001944 |
| Provider Name | Emily Quello |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1639741143 PECOS PAC ID: 4981065141 Enrollment ID: I20230803002921 |
| Provider Name | Jennifer Rae Lovejoy |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1043756455 PECOS PAC ID: 6406297068 Enrollment ID: I20240514001084 |
| Provider Name | Anna Frances Burggraf |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1184402117 PECOS PAC ID: 3173965373 Enrollment ID: I20240520001723 |
| Provider Name | Miranda Skramstad |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932939519 PECOS PAC ID: 6901346550 Enrollment ID: I20240910000894 |
| Mailing Address | Practice Location Address |
|---|---|
| Great Kids Therapy, Ltd 3507 Evergreen Rd N, Fargo, ND 58102-1218 Ph: (701) 261-4643 | Great Kids Therapy, Ltd 3120 25th St S Ste N, Fargo, ND 58103-6110 Ph: (701) 205-4194 |
Ms. Kathleen Sayler, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 6681 56th Ave S, Fargo, ND 58104 Phone: 701-361-9622 | |
Leslie Anne Myer, OTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 3000 32nd Ave S, Fargo, ND 58103 Phone: 701-364-8000 Fax: 701-364-8078 | |
Mrs. Shauna R Nelson, OTR/L, CLT Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 1711 Gold Dr S Ste 120, Fargo, ND 58103 Phone: 701-451-9417 | |
Jeremiah Otteson, MOTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2301 25th St S, Fargo, ND 58103 Phone: 701-417-6222 | |
Kayla Brottlund, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 201 University Dr S, Fargo, ND 58103 Phone: 701-239-3000 | |
Karlene Renae Nelson, OTR Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 3060 Frontier Way S, Fargo, ND 58104 Phone: 701-232-2340 | |
Mrs. Shannon Pfau, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1720 University Dr S, Fargo, ND 58103 Phone: 701-417-5500 Fax: 701-540-0098 |