Individual provider Active NPI

Andrea Landsiedel

  • Speech-Language Pathologist
  • Minot, ND
National Provider Identifier
1710131693
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1000 Issued in ND
Practice address
1000 20TH Ave SW
Minot, ND 58701-6447
Phone
(701) 721-0468
Fax
(701) 760-4868
NPI assigned
Nov 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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 1000 ND Primary

Addresses

Primary practice location

1000 20TH Ave SW
Minot, ND 58701-6447

Mailing address

1712 13TH St NW
Minot, ND 58703-1166
Phone (701) 721-0468

Other identifiers 1

IdentifierTypeStateIssuer
55176MedicaidND

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1000NDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
True North Speech-Language & Literacy Speech-Language Pathologist CurrentSince May 7, 2024 Accepting new patients
Sas Holdings, LLC Speech-Language Pathologist CurrentSince Aug 31, 2025 Accepting new patients

Locations

1000 20th Ave SW
#A
Minot, ND 58701
Phone (701) 347-1713

1000 20th Ave SW
Minot, ND 58701
Phone (701) 347-1713

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": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1710131693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 13TH ST NW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587031166",
            "telephone_number": "701-721-0468",
            "fax_number": "701-760-4868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 20TH AVE SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587016447",
            "telephone_number": "701-721-0468",
            "fax_number": "701-760-4868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDSIEDEL",
        "first_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-05",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "1000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55176",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.