Individual provider Active NPI

Srihimaja Nandamudi, PH.D., CCC-SLP

  • Speech-Language Pathologist
  • Grand Forks, ND
National Provider Identifier
1861973190
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1677 Issued in ND
Practice address
501 N Columbia Rd Stop 8040
Grand Forks, ND 58203-2817
Phone
(701) 777-4909
Fax
(701) 777-4578
NPI assigned
Aug 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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 1677 ND Primary

Addresses

Primary practice location

501 N Columbia Rd Stop 8040
Grand Forks, ND 58203-2817

Mailing address

501 N Columbia Rd Stop 8040
Grand Forks, ND 58203-2817
Phone (701) 777-4909

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1677NDMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1861973190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N COLUMBIA RD STOP 8040",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582032817",
            "telephone_number": "701-777-4909",
            "fax_number": "701-777-4578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N COLUMBIA RD STOP 8040",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582032817",
            "telephone_number": "701-777-4909",
            "fax_number": "701-777-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANDAMUDI",
        "first_name": "SRIHIMAJA",
        "name_prefix": "Dr.",
        "credential": "PH.D., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-24",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "1677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; 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.