Individual provider Active NPI

Rachel Marie Quam, MSCCCSLP

  • Speech-Language Pathologist
  • Devils Lake, ND
National Provider Identifier
1073663357
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
742 Issued in ND
Practice address
412 7TH St NE
Devils Lake, ND 58301-2530
Phone
(701) 347-1188
Fax
(701) 401-5154
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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 742 ND Primary

Addresses

Primary practice location

412 7TH St NE
Devils Lake, ND 58301-2530

Mailing address

412 7TH St NE
Devils Lake, ND 58301-2530
Phone (701) 347-1188

Other identifiers 1

IdentifierTypeStateIssuer
1459138MedicaidND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260325000246 ND Practitioner - Qualified Speech Language Pathologist 6103300892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

425 College Dr S
Suite 15
Devils Lake, ND 58301-3537

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Speakstrong Speech-Language Pathologist CurrentSince Dec 10, 2023 Accepting new patients
Speakstrong Therapy Speech-Language Pathologist Current Accepting new patients
Lake Region Special Education Speech-Language Pathologist Past Accepting new patients

Locations

425 College Dr S
Ste 15
Devils Lake, ND 58301
Phone (701) 347-1188

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1073663357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 7TH ST NE",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583012530",
            "telephone_number": "701-347-1188",
            "fax_number": "701-402-5154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 7TH ST NE",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583012530",
            "telephone_number": "701-347-1188",
            "fax_number": "701-401-5154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAM",
        "first_name": "RACHEL",
        "middle_name": "MARIE",
        "credential": "MSCCCSLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1459138",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Devils Lake, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.