Individual provider Active NPI

Kylie Stuhaug

  • Speech-Language Pathologist
  • Fargo, ND
National Provider Identifier
1538843149
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2436 Issued in ND
Practice address
4152 30TH Ave S
Fargo, ND 58104-8524
Phone
(701) 552-3968
NPI assigned
Jun 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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 2436 ND Primary

Addresses

Primary practice location

4152 30TH Ave S
Fargo, ND 58104-8524

Mailing address

2200 20TH St SW
Jamestown, ND 58401-7500
Phone (701) 252-3850

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231012000705 ND Practitioner - Qualified Speech Language Pathologist 8921453879 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2436NDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Anne Carlsen Center Speech-Language Pathologist CurrentSince Sep 1, 2023 Accepting new patients

Locations

4152 30th Ave S
Fargo, ND 58104
Phone (701) 364-2663

701 3rd St NW
Jamestown, ND 58401
Phone (701) 252-3850

2200 20th St SW
Jamestown, ND 58401
Phone (701) 252-3850

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": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1538843149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 20TH ST SW",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584017500",
            "telephone_number": "701-252-3850",
            "fax_number": "701-952-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4152 30TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048524",
            "telephone_number": "701-552-3968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUHAUG",
        "first_name": "KYLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-14",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "2436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2026; 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.