Individual provider Active NPI

Janet E Grove, MS CCC-SLP

  • Speech-Language Pathologist
  • West Fargo, ND
National Provider Identifier
1386867919
Registry record updated Nov 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
840 Issued in ND
Practice address
1150 Prairie Pkwy Ste 105
West Fargo, ND 58078-3168
Phone
(701) 356-7766
Fax
(701) 356-7765
NPI assigned
Apr 11, 2007
Last updated
Nov 1, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2010

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 840 ND Primary

Addresses

Primary practice location

1150 Prairie Pkwy Ste 105
West Fargo, ND 58078-3168

Mailing address

1150 Prairie Pkwy Ste 105
West Fargo, ND 58078-3168
Phone (701) 356-7766

Other identifiers 2

IdentifierTypeStateIssuer
51043MedicaidND
26666OtherNDND BCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110217000086 ND Practitioner - Qualified Speech Language Pathologist 9032399050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
840NDMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288569600000",
    "number": "1386867919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 PRAIRIE PKWY STE 105",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580783168",
            "telephone_number": "701-356-7766",
            "fax_number": "701-356-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 PRAIRIE PKWY STE 105",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580783168",
            "telephone_number": "701-356-7766",
            "fax_number": "701-356-7765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVE",
        "first_name": "JANET",
        "middle_name": "E",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2010-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51043",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ND BCBS",
            "identifier": "26666",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; 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.