Rebecca Anne Ellingson

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1550 Issued in ND

Practice address

3175 Sienna Dr S Ste 103
Fargo, ND 58104-8910

Phone

(701) 532-1906

Fax

(701) 532-1896

NPI assigned

Jan 3, 2018

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

State licenses

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.

• Interact Therapy LLC

  • Multi-Specialty Clinic/Center
  • Fargo, ND
  • NPI 1740790005
  Medicare reassignment NPD

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1639686397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 SIENNA DR S STE 103",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048910",
            "telephone_number": "701-532-1906",
            "fax_number": "701-532-1896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3175 SIENNA DR S STE 103",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048910",
            "telephone_number": "701-532-1906",
            "fax_number": "701-532-1896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLINGSON",
        "first_name": "REBECCA",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-03",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "1550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Ellenson, PA
• Donna Durand Ellig, MS OTRL
• Amanda Ellingson, RN
• Hailey Ellingson, PSYD
• Lori Ellingson, FNP
• Summer Joy Ellingson, APRN, CNP
• Priscilla L Ellinor, RN, CNP
• Jordan Chase Elliott, ATC
• Zachary Elliott
• Austin Ellis, OTR/L

• Speech-Language Pathologist in Fargo, ND
• Providers in 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 Oct 7, 2021; 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.