Active NPI
Bernadette H Schultz, MS, CCC-SLP
- Speech-Language Pathologist
- Fargo, ND
National Provider Identifier
1619487519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1608
- Practice address
- 4530 Northern Sky Dr
Fargo, ND 58503-5850 - Phone
- (701) 751-6336
- NPI assigned
- Oct 5, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 1608 | ND | Primary |
Addresses
Primary practice location
4530 Northern Sky Dr
Fargo, ND 58503-5850
Mailing address
PO Box 2536
Bismarck, ND 58502-2536
Phone (701) 258-1569
Other practice location 1
3060 Frontier Way S
Fargo, ND 58104-8909
Phone (701) 232-2340
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1608 | Other | ND | ND STATE LICENSE |
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1608 | ND | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Therapy Partners, Inc. | Current | Accepting new patients | |
| The Enrichment Garden | Past | Accepting new patients |
Locations
3060 Frontier Way S
Fargo, ND 58104
Phone (701) 356-4384
Organizations & group practices 2
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.
-
- Early Intervention Provider Agency
- Fargo, ND
- NPI 1104426352
-
- Hearing and Speech Clinic/Center
- Bismarck, ND
- NPI 1730212325
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554076800000",
"number": "1619487519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2536",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585022536",
"telephone_number": "701-258-1569",
"fax_number": "701-223-1669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4530 NORTHERN SKY DR",
"city": "FARGO",
"state": "ND",
"postal_code": "585035850",
"telephone_number": "701-751-6336"
}
],
"practiceLocations": [
{
"address_1": "3060 Frontier Way S",
"address_purpose": "LOCATION",
"city": "Fargo",
"state": "ND",
"postal_code": "581048909",
"country_code": "US",
"telephone_number": "701-232-2340",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SCHULTZ",
"first_name": "BERNADETTE",
"middle_name": "H",
"credential": "MS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-05",
"last_updated": "2019-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "ND",
"license": "1608",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ND STATE LICENSE",
"identifier": "1608",
"state": "ND"
}
],
"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 Apr 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.