Active NPI
Vicki Bostow
- Speech-Language Pathologist
- Minot, ND
National Provider Identifier
1194863886
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 452
- Practice address
- 215 2ND St SE
Minot, ND 58701-3924 - Phone
- (701) 857-4410
- Fax
- (701) 857-4413
- NPI assigned
- Feb 2, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 452 | ND | Primary |
Addresses
Primary practice location
215 2ND St SE
Minot, ND 58701-3924
Mailing address
215 2ND St SE
Minot, ND 58701-3924
Phone (701) 857-4410
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50395 | Medicaid | ND |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 452 | ND | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194863886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 2ND ST SE",
"city": "MINOT",
"state": "ND",
"postal_code": "587013924",
"telephone_number": "701-857-4410",
"fax_number": "701-857-4413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 2ND ST SE",
"city": "MINOT",
"state": "ND",
"postal_code": "587013924",
"telephone_number": "701-857-4410",
"fax_number": "701-857-4413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSTOW",
"first_name": "VICKI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "ND",
"license": "452",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "50395",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minot, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.