Individual provider Active NPI

Bailey Justine Weston Werk, M.S, CF-SLP

  • Speech-Language Pathologist
  • Fargo, ND
National Provider Identifier
1760112577
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2094 Issued in ND
Practice address
4500 36TH Ave S Ste 200
Fargo, ND 58104-5275
Phone
(701) 532-1507
Fax
(701) 532-1529
NPI assigned
Jun 14, 2022
Last updated
Jun 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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 2094 ND Primary

Addresses

Primary practice location

4500 36TH Ave S Ste 200
Fargo, ND 58104-5275

Mailing address

4500 36TH Ave S Ste 200
Fargo, ND 58104-5275
Phone (701) 532-1507

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2094NDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
On Spot Therapy and Orofacial Myology, LLC Speech-Language Pathologist CurrentSince May 19, 2022 Accepting new patients

Locations

4500 36th Ave S
Ste 200
Fargo, ND 58104
Phone (701) 532-1507

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1760112577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 36TH AVE S STE 200",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045275",
            "telephone_number": "701-532-1507",
            "fax_number": "701-532-1529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 36TH AVE S STE 200",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045275",
            "telephone_number": "701-532-1507",
            "fax_number": "701-532-1529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTON WERK",
        "first_name": "BAILEY",
        "middle_name": "JUSTINE",
        "credential": "M.S, CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "2094",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 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.