NPIMap

Organization Active NPI

Progressive Therapy Associates

  • Speech-Language Pathologist
  • Fargo, ND
National Provider Identifier
1699075945
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
957 Issued in ND
Legal business name
PROGRESSIVE THERAPY ASSOCIATES
Practice address
825 28TH St S Ste B
Fargo, ND 58103-2325
Phone
(701) 356-7766
Fax
(701) 356-7765
NPI assigned
Nov 2, 2010
Last updated
Jan 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jodi Lynn Hedstrom, MS CCC-SLPNPI 1528281136
Title
Speech-Language Pathologist
Phone
(701) 356-7766

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 8674 MN
Speech-Language Pathologist 235Z00000X 840 ND
Speech-Language Pathologist 235Z00000X 8076 MN
Speech-Language Pathologist 235Z00000X 957 ND Primary

Addresses

Primary practice location

825 28TH St S Ste B
Fargo, ND 58103-2325

Mailing address

825 28TH St S Ste B
Fargo, ND 58103-2325
Phone (701) 356-7766

Other identifiers 1

IdentifierTypeStateIssuer
0DI79PROtherMNBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

825 28th St S
Ste B
Fargo, ND 58103
Phone (701) 356-7766

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642118400000",
    "number": "1699075945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 28TH ST S STE B",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032325",
            "telephone_number": "701-356-7766",
            "fax_number": "701-356-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 28TH ST S STE B",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032325",
            "telephone_number": "701-356-7766",
            "fax_number": "701-356-7765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE THERAPY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-02",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A",
        "authorized_official_last_name": "HEDSTROM",
        "authorized_official_first_name": "JODI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "701-356-7766",
        "authorized_official_credential": "MS CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "8674",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "840",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "8076",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0DI79PR",
            "state": "MN"
        }
    ],
    "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 Jan 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.