Individual provider Active NPI

Erin Millicent Wark May

  • Speech-Language Pathologist
  • Bemidji, MN
National Provider Identifier
1700215035
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
9201 Issued in MN
Practice address
3835 Supreme CT NW
Suite 2
Bemidji, MN 56601-4446
Phone
(218) 444-8280
NPI assigned
Nov 7, 2013
Last updated
Nov 7, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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 9201 MN Primary

Addresses

Primary practice location

3835 Supreme CT NW
Suite 2
Bemidji, MN 56601-4446

Mailing address

25627 County Highway 48
Osage, MN 56570-9502
Phone (218) 261-0867

Other names 1

  • Erin Millicent Wark Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9201MNMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1700215035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25627 COUNTY HIGHWAY 48",
            "city": "OSAGE",
            "state": "MN",
            "postal_code": "565709502",
            "telephone_number": "218-261-0867",
            "fax_number": "218-444-8337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3835 SUPREME CT NW",
            "address_2": "SUITE 2",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014446",
            "telephone_number": "218-444-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARK MAY",
        "first_name": "ERIN",
        "middle_name": "MILLICENT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-07",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "9201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "WARK",
            "middle_name": "MILLICENT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bemidji, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; 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.