Active NPI
Ellen Renee Becker
- Speech-Language Pathologist
- Dickinson, ND
National Provider Identifier
1720116171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 23
- Practice address
- 444 4TH St W
Dickinson, ND 58601-4951 - Phone
- (701) 456-0015
- Fax
- (701) 456-0001
- NPI assigned
- Feb 28, 2007
- Sex
- Female
- Sole proprietor
- No
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.
-
- Local Education Agency (LEA)
- Dickinson, ND
- NPI 1952470700
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
| License | State | Type | Specialty |
|---|---|---|---|
| 23 | ND | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dickinson Public Schools | Past | Accepting new patients |
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 23 | ND | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
444 4TH St W
Dickinson, ND 58601-4951
Mailing address
1491 13TH St W
Dickinson, ND 58601-3547
Phone (701) 483-1491
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 54098 | Medicaid | ND |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 9, 2007.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1720116171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1491 13TH ST W",
"city": "DICKINSON",
"state": "ND",
"postal_code": "586013547",
"telephone_number": "701-483-1491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "444 4TH ST W",
"city": "DICKINSON",
"state": "ND",
"postal_code": "586014951",
"telephone_number": "701-456-0015",
"fax_number": "701-456-0001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECKER",
"first_name": "ELLEN",
"middle_name": "RENEE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-28",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "ND",
"license": "23",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "54098",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dickinson, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.