Phyllis Jean Magelky, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

320 Issued in ND

Practice address

1112 Nodak Dr S Ste 135
Fargo, ND 58103-8744

Phone

(701) 364-9070

Fax

(701) 364-9071

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Other names 1

• Mrs. Phyllis Jean Magelky Professional 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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256169600000",
    "number": "1407968522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3309 FIECHTNER DR S STE D",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032375",
            "telephone_number": "701-364-9070",
            "fax_number": "701-364-9071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 NODAK DR S STE 135",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581038744",
            "telephone_number": "701-364-9070",
            "fax_number": "701-364-9071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGELKY",
        "first_name": "PHYLLIS",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "320",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "5882",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "27397",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "11674",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4043140-00",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "5G158N-MA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58789",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1033438",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHYLLIS",
            "last_name": "MAGELKY",
            "middle_name": "JEAN",
            "prefix": "MRS.",
            "credential": "M.S. CCC-SLP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Dema Magar
• Kausila Magar
• Prem Magar
• Raj Magar
• Elizabeth Ann Gillham Magee, LRD
• Samantha Magelky
• Sara Magelky, LRD
• Thomas R Magill, MD
• Mason Magle, PHARMD, BCPS
• Megan Michele Magle, PHARMD

• Speech-Language Pathologist in Fargo, ND
• Providers in Fargo, 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 Oct 22, 2009; 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.