Individual provider Active NPI

Louis J Demaio, PHD CCCSLP

  • Speech-Language Pathologist
  • Moorhead, MN
National Provider Identifier
1013009638
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7236 Issued in MN
Practice address
1104 7TH Ave South
Msum Box 119
Moorhead, MN 56563-0001
Phone
(218) 477-4643
Fax
(218) 477-4392
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7236 MN Primary

Addresses

Primary practice location

1104 7TH Ave South
Msum Box 119
Moorhead, MN 56563-0001

Mailing address

1104 7TH Ave South
Msum Box 119
Moorhead, MN 56563-0001
Phone (218) 477-5953

Other identifiers 3

IdentifierTypeStateIssuer
51835MedicaidND
62B56DEOtherMNBCBS
18425OtherNDBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota State Colleges & Universities Speech-Language Pathologist Past Accepting new patients
Minnesota State Colleges & Universities Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013009638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 7TH AVE SOUTH",
            "address_2": "MSUM BOX 119",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565630001",
            "telephone_number": "218-477-5953",
            "fax_number": "218-477-4392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 7TH AVE SOUTH",
            "address_2": "MSUM BOX 119",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565630001",
            "telephone_number": "218-477-4643",
            "fax_number": "218-477-4392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMAIO",
        "first_name": "LOUIS",
        "middle_name": "J",
        "credential": "PHD CCCSLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "7236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51835",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "62B56DE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "18425",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorhead, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.