Revolution Speech Therapy

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

REVOLUTION SPEECH THERAPY

Practice address

2029 Boston Dr
Bismarck, ND 58504-7417

Phone

(701) 202-7723

NPI assigned

Mar 12, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Wendy Hafner-Bakken, MS, CCC-SLPNPI 1538297601

Title

Speech-Language Pathologist

Phone

(701) 202-7723

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wendy Hafner-Bakken

  • Speech-Language Pathologist
  • Bismarck, ND
  • NPI 1538297601
  NPD Authorized official

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

{
    "created_epoch": "1710201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710892800000",
    "number": "1760240808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2029 BOSTON DR",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585047417",
            "telephone_number": "701-202-7723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2029 BOSTON DR",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585047417",
            "telephone_number": "701-202-7723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVOLUTION SPEECH THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-12",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A",
        "authorized_official_last_name": "HAFNER-BAKKEN",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "701-202-7723",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brielle Mary Renz, DMD
• Carmen Rae Repnow, OT
• Ariana Retuta
• Jacob P Retzer, PT, DPT
• Tawniel Retzlaff
• Ricardo Jose Reyes, PHARMD
• John T Reynolds, MD
• Robert Ray Reynolds, M.D.
• Thulisile Sandra Ribombo
• Amber C Rice, MS, CCC-SLP

• Speech-Language Pathologist in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Speech-Language Pathologist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.