Active NPI
Sandra Hendricksen Martire, M.S, M.B.A
- Speech-Language Pathologist
- Bismarck, ND
National Provider Identifier
1154748895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1318
- Practice address
- 630 Oberhausen Dr
Bismarck, ND 58504-7056 - Phone
- (701) 319-1917
- Fax
- (701) 255-4696
- NPI assigned
- Mar 19, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 1318 | ND | Primary |
Addresses
Primary practice location
630 Oberhausen Dr
Bismarck, ND 58504-7056
Mailing address
630 Oberhausen Dr
Bismarck, ND 58504-7056
Phone (701) 319-1917
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
- Credentials
- Master of Business Administration, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1318 | ND | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395187200000",
"number": "1154748895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 OBERHAUSEN DR",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585047056",
"telephone_number": "701-319-1917",
"fax_number": "701-255-4696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 OBERHAUSEN DR",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585047056",
"telephone_number": "701-319-1917",
"fax_number": "701-255-4696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIRE",
"first_name": "SANDRA",
"middle_name": "HENDRICKSEN",
"name_prefix": "Miss",
"credential": "M.S, M.B.A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-19",
"last_updated": "2014-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "ND",
"license": "1318",
"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 Mar 19, 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.