Individual provider Active NPI

Janette Elizabeth Ann Venaas Gilbraith

  • Speech-Language Pathologist
  • Fargo, ND
National Provider Identifier
1376699744
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
528 Issued in ND
Practice address
10318 6TH St S
Fargo, ND 58104-8116
Phone
(701) 238-3908
Fax
(701) 232-2330
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 528 ND Primary
Speech-Language Pathologist 235Z00000X 7852 MN

Addresses

Primary practice location

10318 6TH St S
Fargo, ND 58104-8116

Mailing address

10318 6TH St S
Fargo, ND 58104-8116
Phone (701) 238-3908

Other identifiers 1

IdentifierTypeStateIssuer
55035MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
528NDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Quotable Kids Pediatric Therapy Clinic, PLLC CurrentSince Apr 1, 2020 Accepting new patients
Pediatric Therapy Partners, Inc. CurrentSince Nov 1, 2020 Accepting new patients
Pediatric Speech Solutions Incorporated Speech-Language Pathologist Past Accepting new patients

Locations

3060 Frontier Way S
Fargo, ND 58104
Phone (701) 356-4384

2600 Demers Ave
Ste 101
Grand Forks, ND 58201
Phone (701) 757-3045

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376699744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10318 6TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048116",
            "telephone_number": "701-238-3908",
            "fax_number": "701-232-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10318 6TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048116",
            "telephone_number": "701-238-3908",
            "fax_number": "701-232-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENAAS GILBRAITH",
        "first_name": "JANETTE",
        "middle_name": "ELIZABETH ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "528",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "7852",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55035",
            "state": "ND"
        }
    ],
    "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 Jul 8, 2007; 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.