Individual provider Active NPI

Jennifer L Gowan, AU.D.

  • Audiologist
  • Grand Forks, ND
National Provider Identifier
1114281540
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1224 Issued in ND
Practice address
1200 S Columbia Rd
Grand Forks, ND 58201-4036
Phone
(701) 780-5000
NPI assigned
Jun 29, 2012
Last updated
Nov 4, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1224 ND Primary

Addresses

Primary practice location

1200 S Columbia Rd
Grand Forks, ND 58201-4036

Mailing address

1200 S Columbia Rd
Grand Forks, ND 58201-4036
Phone (701) 780-5000

Other names 1

  • Jennifer Sliper Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130306000474 ND Practitioner - Qualified Audiologist 8123273661 Reassigns benefits to 1 organization
I20180301000373 MN Practitioner - Qualified Audiologist 8123273661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Altru Health SystemGroup PAC ID 1355251604, shared by 14 NPIs, 675 clinicians

Practice addresses (Care Compare)

1001 7TH St NE
Devils Lake, ND 58301-2719
Phone (701) 662-2157

1380 S Columbia Rd
Grand Forks, ND 58201-4059
Phone (701) 795-2000

400 S Minnesota St
Crookston, MN 56716-1808
Phone (218) 281-9100

4440 S Washington St
Grand Forks, ND 58201-7245
Phone (701) 780-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10027MNMDNeurology Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Altru Health System CurrentSince Nov 2, 2015 Accepting new patients
Altru Health System CurrentSince Nov 2, 2015 Accepting new patients
Altru Health System Current Accepting new patients
Altru Health System CurrentSince Jan 22, 2018 Accepting new patients
Altru Health System Past Accepting new patients
Clinic Pharmacy Inc Past Accepting new patients
Quotable Kids Pediatric Therapy Clinic, PLLC PastSince Jun 19, 2013 Accepting new patients
Cavalier Optometry Clinic LTD Past Accepting new patients

Locations

400 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9100

607 Demers Ave
East Grand Forks, MN 56721
Phone (218) 773-0357

19120 200th St
Greenbush, MN 56726
Phone (218) 782-2400

711 Delmore Dr
Roseau, MN 56751
Phone (218) 463-1365

412 Main Ave NE
Warroad, MN 56763
Phone (218) 386-2020

201 E 3rd Ave S
Cavalier, ND 58220
Phone (701) 265-8338

1001 7th St NE
Devils Lake, ND 58301
Phone (701) 662-2157

1200 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5243

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

Organizations & group practices 8

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446595200000",
    "number": "1114281540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S COLUMBIA RD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014036",
            "telephone_number": "701-780-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S COLUMBIA RD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014036",
            "telephone_number": "701-780-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOWAN",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-29",
        "last_updated": "2015-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "ND",
            "license": "1224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SLIPER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Nov 4, 2015; 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.