Sprout Pediatric Therapy, PLLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

SPROUT PEDIATRIC THERAPY, PLLC

Practice address

21 Main St S Ste 101a
Minot, ND 58701-3872

Phone

(701) 500-0104

NPI assigned

May 7, 2021

Organization subpart

No

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

Authorized official

Name

Candace R Larson, MS, CCC-SLPNPI 1679093504

Title

Speech-Language Pathologist

Phone

(701) 500-0104

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Candace Larson, MS CCC-SLP

  • Speech-Language Pathologist
  • Minot, ND
  • NPI 1679093504
  NPD Authorized official
• Katelyn Rose Fornshell

  • Speech-Language Pathologist
  • Minot, ND
  • NPI 1124539291
  NPD

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620345600000",
    "number": "1487238259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 13TH ST SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587015784",
            "telephone_number": "701-500-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 MAIN ST S STE 101A",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587013872",
            "telephone_number": "701-500-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPROUT PEDIATRIC THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-07",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "701-500-0104",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lucinda Stapleton

• 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 May 7, 2021; 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.