Individual provider Active NPI

Erinpatricia Flaherty Bommersbach, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Devils Lake, ND
National Provider Identifier
1629755392
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
213 5TH St NE
Devils Lake, ND 58301-2425
Phone
(701) 662-2216
NPI assigned
Jul 3, 2023
Last updated
Jul 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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 Primary

Addresses

Primary practice location

213 5TH St NE
Devils Lake, ND 58301-2425

Mailing address

2401 14TH Ave SW
Devils Lake, ND 58301-8632
Phone (701) 351-0988

Other names 1

  • Erin Patricia Flaherty Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240506004472 ND Practitioner - Qualified Speech Language Pathologist 3577903624 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
583 Therapy Speech-Language Pathologist CurrentSince Apr 15, 2024 Accepting new patients

Locations

213 5th St NE
Devils Lake, ND 58301
Phone (701) 662-2216

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1629755392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 14TH AVE SW",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583018632",
            "telephone_number": "701-351-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 5TH ST NE",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583012425",
            "telephone_number": "701-662-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMMERSBACH",
        "first_name": "ERINPATRICIA",
        "middle_name": "FLAHERTY",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "FLAHERTY",
            "middle_name": "PATRICIA",
            "credential": "M.S., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Devils Lake, ND

Sources for this page

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