Individual provider Active NPI

Sara Wanner, CCC-SLP

  • Speech-Language Pathologist
  • Bismarck, ND
National Provider Identifier
1104492032
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1953 Issued in ND
Practice address
1000 E Calgary Ave Ste 1
Bismarck, ND 58503-5648
Phone
(701) 355-6044
NPI assigned
Jun 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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 1953 ND Primary

Addresses

Primary practice location

1000 E Calgary Ave Ste 1
Bismarck, ND 58503-5648

Mailing address

5143 Redcoat Loop
Bismarck, ND 58503-7865
Phone (701) 426-6565

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210716000750 ND Practitioner - Qualified Speech Language Pathologist 4587066287 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Innovative Therapy Solutions and Consulting LLCGroup PAC ID 1759703192, 17 clinicians

Practice addresses (Care Compare)

2550 Windsor PL N
Mandan, ND 58554-8151
Phone (701) 320-2488

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1953NDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Therapy Partners, Inc. CurrentSince May 26, 2021 Accepting new patients
Innovative Therapy Solutions & Consulting LLC CurrentSince Aug 1, 2022 Accepting new patients
Pediatric Therapy Partners, Inc. Speech-Language Pathologist CurrentSince May 26, 2021 Accepting new patients
Empowered Kids Pediatric Therapy Speech-Language Pathologist CurrentSince Sep 4, 2022 Accepting new patients

Locations

1929 N Washington St
Ste H
Bismarck, ND 58501
Phone (701) 220-0479

1000 E Calgary Ave
Ste 1
Bismarck, ND 58503
Phone (701) 214-7151

3060 Frontier Way S
Fargo, ND 58104
Phone (701) 356-4384

Organizations & group practices 4

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": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1104492032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5143 REDCOAT LOOP",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585037865",
            "telephone_number": "701-426-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E CALGARY AVE STE 1",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585035648",
            "telephone_number": "701-355-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANNER",
        "first_name": "SARA",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-01",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "1953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; 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.