Individual provider Active NPI

Erin Jore

  • Speech-Language Pathologist
  • Fargo, ND
National Provider Identifier
1275953762
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1341 Issued in ND
Practice address
3001 11TH St S
Fargo, ND 58103-6048
Phone
(701) 356-0062
Fax
(701) 356-5412
NPI assigned
Apr 23, 2014
Last updated
Jun 3, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

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 1341 ND Primary

Addresses

Primary practice location

3001 11TH St S
Fargo, ND 58103-6048

Mailing address

3001 11TH St S
Fargo, ND 58103-6048
Phone (701) 356-0062

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210922000399 MN Practitioner - Qualified Speech Language Pathologist 9537384904

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1341NDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Beyond Boundaries Occupational Therapy, Inc. Speech-Language Pathologist PastSince Jul 1, 2009 Accepting new patients

Organizations & group practices 1

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": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1275953762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 11TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036048",
            "telephone_number": "701-356-0062",
            "fax_number": "701-356-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 11TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036048",
            "telephone_number": "701-356-0062",
            "fax_number": "701-356-5412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORE",
        "first_name": "ERIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-23",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "1341",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 3, 2014; 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.