Individual provider Active NPI

Taylor Nicole Eide, SLP

  • Speech-Language Pathologist
  • Fargo, ND
National Provider Identifier
1780250670
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
528920 Issued in MN
Practice address
6046 14TH St S
Fargo, ND 58104-7226
Phone
(701) 404-0997
Fax
(701) 566-8876
NPI assigned
Jun 1, 2021
Last updated
Jul 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 528920 MN Primary
Behavior Technician 106S00000X NU

Addresses

Primary practice location

6046 14TH St S
Fargo, ND 58104-7226

Mailing address

6046 14TH St S
Fargo, ND 58104-7226
Phone (701) 404-0997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250807000784 MN Practitioner - Qualified Speech Language Pathologist 5799283032 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Serene Counseling PLLC Speech-Language Pathologist CurrentSince Aug 1, 2025 Accepting new patients

Locations

6046 14th St S
Fargo, ND 58104
Phone (701) 471-7092

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": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1780250670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6046 14TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047226",
            "telephone_number": "701-404-0997",
            "fax_number": "701-566-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6046 14TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047226",
            "telephone_number": "701-404-0997",
            "fax_number": "701-566-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIDE",
        "first_name": "TAYLOR",
        "middle_name": "NICOLE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-01",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "528920",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Jul 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.