Individual provider Active NPI

Allison Henrickson, SLP

  • Speech-Language Pathologist
  • Grafton, ND
National Provider Identifier
1376199810
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1757 Issued in ND
Practice address
1542 School Rd
Grafton, ND 58237-1715
Phone
(701) 352-1739
NPI assigned
Aug 12, 2019
Last updated
Aug 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

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 1757 ND Primary

Addresses

Primary practice location

1542 School Rd
Grafton, ND 58237-1715

Mailing address

516 Cooper Ave Ste 102
Grafton, ND 58237-1512
Phone (701) 352-2574

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200811001448 MN Practitioner - Qualified Speech Language Pathologist 6406271295 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10278MNMDPeriodontist
1757NDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health Network North CurrentSince Jun 11, 2019 Accepting new patients
Sanford Health Network North CurrentSince Jun 11, 2019 Accepting new patients
Sanford Health Network North Current Accepting new patients
Upper Valley Special Education Speech-Language Pathologist PastSince Aug 18, 2019 Accepting new patients
Sanford Health Network North Past Accepting new patients

Locations

120 Labree Ave S
Thief Rvr Fls, MN 56701
Phone (218) 681-0600

1720 US Highway 59 SE
Thief Rvr Fls, MN 56701
Phone (218) 681-4747

3001 Sanford Pkwy
Thief Rvr Fls, MN 56701
Phone (218) 681-4240

Organizations & group practices 5

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": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1376199810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 COOPER AVE STE 102",
            "city": "GRAFTON",
            "state": "ND",
            "postal_code": "582371512",
            "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": "1542 SCHOOL RD",
            "city": "GRAFTON",
            "state": "ND",
            "postal_code": "582371715",
            "telephone_number": "701-352-1739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRICKSON",
        "first_name": "ALLISON",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-12",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "1757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grafton, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.