Individual provider Active NPI

Courtnie Jean Roesler, M.S, CF-SLP

  • Speech-Language Pathologist
  • Fargo, ND
National Provider Identifier
1679157408
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
4500 36TH Ave S Ste 200
Fargo, ND 58104-5275
Phone
(701) 532-1507
NPI assigned
May 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

4500 36TH Ave S Ste 200
Fargo, ND 58104-5275

Mailing address

1412 E Gateway Cir S Apt 101
Fargo, ND 58103-3651
Phone (701) 540-1500

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.onspottherapies.com/

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211029001117 ND Practitioner - Qualified Speech Language Pathologist 1052709748 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1956NDMDPublic Health Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
On Spot Therapy and Orofacial Myology, LLC Speech-Language Pathologist CurrentSince Oct 18, 2021 Accepting new patients

Locations

4500 36th Ave S
Ste 200
Fargo, ND 58104
Phone (701) 532-1507

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": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1679157408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 E GATEWAY CIR S APT 101",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033651",
            "telephone_number": "701-540-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 36TH AVE S STE 200",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045275",
            "telephone_number": "701-532-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROESLER",
        "first_name": "COURTNIE",
        "middle_name": "JEAN",
        "credential": "M.S, CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-07",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.onspottherapies.com/",
            "affiliation": "N",
            "address_1": "4500 36th Ave S Ste 200",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581045275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 May 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.