Individual provider Active NPI

Serena E Ratzlaff, MS, SLP

  • Speech-Language Pathologist
  • Grand Forks, ND
National Provider Identifier
1871334607
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2680 Issued in ND
Practice address
2810 19TH Ave S
Grand Forks, ND 58201-5957
Phone
(701) 222-3175
Fax
(701) 222-3186
NPI assigned
Jun 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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 2680 ND Primary

Addresses

Primary practice location

2810 19TH Ave S
Grand Forks, ND 58201-5957

Mailing address

2625 N 19TH St
Bismarck, ND 58503-0574
Phone (701) 222-3175

Other identifiers 1

IdentifierTypeStateIssuer
1492518MedicaidND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240920002381 ND Practitioner - Qualified Speech Language Pathologist 8527509280 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2680NDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Red Door Pediatric Therapy, Inc Speech-Language Pathologist CurrentSince Jul 12, 2024 Accepting new patients
Solutions Counseling Services, Inc. PastSince Jun 9, 2024 Accepting new patients

Locations

2810 19th Ave S
Grand Forks, ND 58201
Phone (701) 222-3175

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1871334607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 N 19TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030574",
            "telephone_number": "701-222-3175",
            "fax_number": "701-222-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 19TH AVE S",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582015957",
            "telephone_number": "701-222-3175",
            "fax_number": "701-222-3186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATZLAFF",
        "first_name": "SERENA",
        "middle_name": "E",
        "credential": "MS, SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "2680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1492518",
            "state": "ND"
        }
    ],
    "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 Jun 17, 2024; 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.