Individual provider Active NPI

Mary Jo Schill, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Grand Forks, ND
National Provider Identifier
1487876256
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
119 Issued in ND
Practice address
290 Centennial Dr Stop 8040
Grand Forks, ND 58202-8040
Phone
(701) 777-3727
Fax
(701) 777-4578
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
No

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 119 ND Primary

Addresses

Primary practice location

290 Centennial Dr Stop 8040
Grand Forks, ND 58202-8040

Mailing address

290 Centennial Dr Stop 8040
Grand Forks, ND 58202-8040
Phone (701) 777-3727

Other identifiers 1

IdentifierTypeStateIssuer
51628MedicaidND

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
119NDMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Dakota Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 1

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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487876256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 CENTENNIAL DR STOP 8040",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582028040",
            "telephone_number": "701-777-3727",
            "fax_number": "701-777-4578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 CENTENNIAL DR STOP 8040",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582028040",
            "telephone_number": "701-777-3727",
            "fax_number": "701-777-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHILL",
        "first_name": "MARY JO",
        "name_prefix": "Ms.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51628",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, 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.