Heather Jean Gravley, MS

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

876 Issued in ND

Practice address

215 2ND St SE
Minot, ND 58701-3924

Phone

(701) 857-4410

Fax

(701) 857-4413

NPI assigned

Mar 13, 2007

Last updated

Mar 4, 2019By 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

Other identifiers 1

Other names 1

• Heather Jean Nelson Beck Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1326171950",
    "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": "GRAVLEY",
        "first_name": "HEATHER",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54638",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "NELSON BECK",
            "middle_name": "JEAN",
            "credential": "MS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Minot, ND
• Providers in Minot, 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 Mar 4, 2019; 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.