Casey L Brudvik

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

1876 Charleswood Estates Dr
West Fargo, ND 58078-4203

Phone

(701) 347-1782

Fax

(701) 404-8274

NPI assigned

Jun 16, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Myna Therapy Services PLLC

  • Multi-Specialty Clinic/Center
  • Fargo, ND
  • NPI 1427788629

  Speech-Language Pathologist

  Medicare reassignment NPD
• Myna Early Intervention LLC

  • Early Intervention Provider Agency
  • Fargo, ND
  • NPI 1639981343
  NPD (past)

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

{
    "created_epoch": "1686873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1487339677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1876 CHARLESWOOD ESTATES DR",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580784203",
            "telephone_number": "701-347-1782",
            "fax_number": "701-404-8274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1876 CHARLESWOOD ESTATES DR",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580784203",
            "telephone_number": "701-347-1782",
            "fax_number": "701-404-8274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUDVIK",
        "first_name": "CASEY",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-16",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shea Brogren, OTR
• Nicole Brower
• Abigail Brown
• Rachelle Brown, MS, LAPC
• Bruce L. Redington, D.C.
• Carla Buchholz
• Kacie Buchholz
• Caitlin Bultman
• Kayla Jo Bunkowski, PSY.S., NCSP
• Andrew Joseph Burgard, M.D.

• Speech-Language Pathologist in West Fargo, ND
• Providers in West 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 Jun 16, 2023; 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.