Nicholas B Ertsgaard, M.S. CF-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

17386 Issued in OR

Practice address

3220 Liberty Rd S
Salem, OR 97302-4560

Phone

(503) 749-9743

NPI assigned

Apr 2, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

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.

• Creating Pathways

  • Speech-Language Pathologist
  • Salem, OR
  • NPI 1306284518

  Multi-Specialty

  NPD (past)
• Pediatric Therapy Services Inc

  • Pediatric Occupational Therapist
  • Gresham, OR
  • NPI 1700842531

  Multi-Specialty

  NPD (past)
• Sensible Speech-Language Pathology, Inc

  • Speech-Language Pathologist
  • Salem, OR
  • NPI 1144645102

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1215516828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5191 SEEGER LN SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973061986",
            "telephone_number": "503-983-5573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 LIBERTY RD S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024560",
            "telephone_number": "503-749-9743"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1475 Capitol St NE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973017850",
            "country_code": "US",
            "telephone_number": "971-599-1712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERTSGAARD",
        "first_name": "NICHOLAS",
        "middle_name": "B",
        "credential": "M.S. CF-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-02",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "17386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nertsgaard@northwestrehab.com",
            "affiliation": "Y",
            "affiliationName": "Northwest Rehabilitation Associates, Inc.",
            "address_1": "3220 Liberty Rd S",
            "city": "Salem",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973024560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Barbara Suzzanne Ernsdorff
• Jeremy Wade Ernst, LPC
• Melody Erorita, PHARMD
• Tifani E Erpelding
• P Christine Ertl, LCSW
• Lawrence Thomas Eschelman, M.D.
• Paula Lorene Eschtruth, DO
• Elder Escobar
• Pamela C Escobar, LMT
• Juan Carlos Esguerra, MD

• Speech-Language Pathologist in Salem, OR
• Providers in Salem, OR by specialty
• Speech-Language Pathologist in Oregon

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

Verify at the official NPI Registry.