Active NPI
Nancy Lee Kienzle
- Speech-Language Pathologist
- Dickinson, ND
National Provider Identifier
1861523904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 662
- Practice address
- 444 4TH St W
Dickinson, ND 58601-4951 - Phone
- (701) 456-0012
- Fax
- (701) 456-0005
- NPI assigned
- Mar 8, 2007
- Last updated
- Jul 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 662 | ND | Primary |
Addresses
Primary practice location
444 4TH St W
Dickinson, ND 58601-4951
Mailing address
846 13TH St W
Dickinson, ND 58601-3535
Phone (701) 225-1032
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 59657 | Medicaid | ND |
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 |
|---|---|---|---|
| 662 | ND | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dickinson Public Schools | Past | Accepting new patients |
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.
-
- Local Education Agency (LEA)
- Dickinson, ND
- NPI 1952470700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1861523904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "846 13TH ST W",
"city": "DICKINSON",
"state": "ND",
"postal_code": "586013535",
"telephone_number": "701-225-1032"
},
{
"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": "701-456-0012",
"fax_number": "701-456-0005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIENZLE",
"first_name": "NANCY",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-08",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "ND",
"license": "662",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "59657",
"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.