Courtney Ellertson, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1371 Issued in ND

Practice address

516 Cooper Ave
Grafton, ND 58237-1512

Phone

(701) 352-2574

Fax

(701) 352-0188

NPI assigned

Sep 5, 2014

Last updated

Sep 5, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1245631571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 272",
            "city": "GRAFTON",
            "state": "ND",
            "postal_code": "582370272",
            "telephone_number": "701-352-2574",
            "fax_number": "701-352-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 COOPER AVE",
            "city": "GRAFTON",
            "state": "ND",
            "postal_code": "582371512",
            "telephone_number": "701-352-2574",
            "fax_number": "701-352-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLERTSON",
        "first_name": "COURTNEY",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-05",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "1371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Grafton, ND
• Providers in Grafton, ND by specialty
• Speech-Language Pathologist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.

Verify at the official NPI Registry.