Individual provider Active NPI

Ellen Renee Becker

  • Speech-Language Pathologist
  • Dickinson, ND
National Provider Identifier
1720116171
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
23 Issued in ND
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.

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
23NDMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dickinson Public Schools Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 23 ND Primary

Addresses

NPPES NPI Registry

Primary 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
IdentifierTypeStateIssuer
54098MedicaidND

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.

Verify at the official NPI Registry.