Individual provider Active NPI

Kaela M Laudal, SLP

  • Speech-Language Pathologist
  • West Fargo, ND
National Provider Identifier
1104142066
Registry record updated Dec 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
207 Main Ave W
West Fargo, ND 58078-1725
Phone
(701) 356-2000
Fax
(701) 356-2009
NPI assigned
Apr 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP 1959 ID
Speech-Language Pathologist 235Z00000X ND Primary

Addresses

Primary practice location

207 Main Ave W
West Fargo, ND 58078-1725

Mailing address

5481 47TH Ave S
Fargo, ND 58104-6071
Phone (701) 629-0400

Other names 1

  • Kaela M Laudal Former name

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

State licenses

LicenseStateTypeSpecialty
SLP 1959IDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
West Fargo Public School District 6 Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 1

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": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419292800000",
    "number": "1104142066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5481 47TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046071",
            "telephone_number": "701-629-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 MAIN AVE W",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580781725",
            "telephone_number": "701-356-2000",
            "fax_number": "701-356-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUDAL",
        "first_name": "KAELA",
        "middle_name": "M",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2014-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP 1959",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAELA",
            "last_name": "LAUDAL",
            "middle_name": "M",
            "credential": "SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.