Individual provider Active NPI

Jessica Ann Sporbert, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Grand Forks, ND
National Provider Identifier
1013054063
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
818 Issued in ND
Practice address
2400 47TH Ave S
Grand Forks, ND 58201-3405
Phone
(701) 746-2230
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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 818 ND Primary

Addresses

Primary practice location

2400 47TH Ave S
Grand Forks, ND 58201-3405

Mailing address

818 14TH Ave S
Grand Forks, ND 58201-5506
Phone (701) 746-0672

Other practice location 1

293 Centennial Dr Stop 7132
Grand Forks, ND 58202-6066
Phone (701) 777-3745

Other practice location 2

501 N Columbia Rd Stop 7132
Grand Forks, ND 58203-2817
Phone (701) 777-3745

Other identifiers 1

IdentifierTypeStateIssuer
1459735MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160808001614 ND Practitioner - Qualified Speech Language Pathologist 0648564021 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Dakota Current Accepting new patients
University of North Dakota Speech-Language Pathologist CurrentSince Jun 23, 2019 Accepting new patients
Little Miracles, Inc. CurrentSince Jun 10, 2016 Accepting new patients

Locations

501 N Columbia Rd
Stop 7132
Grand Forks, ND 58203
Phone (701) 777-3691

501 N Columbia Rd
Grand Forks, ND 58203
Phone (701) 777-3067

2200 Library Cir
Grand Forks, ND 58201
Phone (701) 757-2155

2951 S 34th St
Grand Forks, ND 58201
Phone (701) 772-3851

293 Centennial Dr
Stop 7132
Grand Forks, ND 58202
Phone (701) 777-3745

Organizations & group practices 3

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1013054063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 14TH AVE S",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582015506",
            "telephone_number": "701-746-0672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 47TH AVE S",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582013405",
            "telephone_number": "701-746-2230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "293 Centennial Dr Stop 7132",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582026066",
            "country_code": "US",
            "telephone_number": "701-777-3745",
            "fax_number": "701-777-3845",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 N Columbia Rd Stop 7132",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582032817",
            "country_code": "US",
            "telephone_number": "701-777-3745",
            "fax_number": "701-777-3845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPORBERT",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1459735",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.