Individual provider Active NPI

Anna Amundson

  • Speech-Language Pathologist
  • Grand Forks, ND
National Provider Identifier
1265125546
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2390 Issued in ND
Practice address
2512 S Washington St Ste C
Grand Forks, ND 58201-6772
Phone
(701) 330-4818
NPI assigned
Jun 1, 2023
Last updated
Jun 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2390 ND Primary

Addresses

Primary practice location

2512 S Washington St Ste C
Grand Forks, ND 58201-6772

Mailing address

2512 S Washington St Ste C
Grand Forks, ND 58201-6772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241023002386 ND Practitioner - Qualified Speech Language Pathologist 9436682911 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2390NDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chelsey Kjono Speech-Language Pathologist CurrentSince Jun 4, 2023 Accepting new patients

Locations

2512 S Washington St
Ste C
Grand Forks, ND 58201
Phone (701) 330-4818

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1265125546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 S WASHINGTON ST STE C",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 S WASHINGTON ST STE C",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016772",
            "telephone_number": "701-330-4818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMUNDSON",
        "first_name": "ANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-01",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "2390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.