Active NPI
Ailsa Anne Falck, MA, SLP
- Speech-Language Pathologist
- Fargo, ND
National Provider Identifier
1154921914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1890
- Practice address
- 1720 University Dr S
Fargo, ND 58103-4940 - Phone
- (701) 417-4085
- NPI assigned
- Oct 29, 2020
- 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 | 1890 | ND | Primary |
Addresses
Primary practice location
1720 University Dr S
Fargo, ND 58103-4940
Mailing address
1720 University Dr S
Fargo, ND 58103-4940
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1890 | Other | ND | NORTH DAKOTA STATE BOARD OF EXAMINERS |
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1890 | ND | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632700800000",
"number": "1154921914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1720 UNIVERSITY DR S",
"city": "FARGO",
"state": "ND",
"postal_code": "581034940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1720 UNIVERSITY DR S",
"city": "FARGO",
"state": "ND",
"postal_code": "581034940",
"telephone_number": "701-417-4085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FALCK",
"first_name": "AILSA",
"middle_name": "ANNE",
"name_prefix": "Ms.",
"credential": "MA, SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-29",
"last_updated": "2021-09-27",
"certification_date": "2021-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "ND",
"license": "1890",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTH DAKOTA STATE BOARD OF EXAMINERS",
"identifier": "1890",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.