Individual provider Active NPI

Heidi Avelsgard, MS. CCC-SLP

  • Speech-Language Pathologist
  • Bismarck, ND
National Provider Identifier
1679920706
Registry record updated Nov 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1485 Issued in ND
Practice address
2625 N 19TH St
Bismarck, ND 58503-0574
Phone
(701) 222-3175
NPI assigned
May 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2019

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 1485 ND Primary

Addresses

Primary practice location

2625 N 19TH St
Bismarck, ND 58503-0574

Mailing address

4530 Northern Sky Dr
Bismarck, ND 58503-8534
Phone (701) 751-6336

Other identifiers 1

IdentifierTypeStateIssuer
1467732MedicaidND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160721001478 ND Practitioner - Qualified Speech Language Pathologist 8729371265 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1485NDMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Red Door Pediatric Therapy, Inc Speech-Language Pathologist PastSince May 25, 2022 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1679920706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 NORTHERN SKY DR",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585038534",
            "telephone_number": "701-751-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 N 19TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030574",
            "telephone_number": "701-222-3175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVELSGARD",
        "first_name": "HEIDI",
        "credential": "MS. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "1485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467732",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; 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.