Active NPI
Kristin Mary Gillig Casallas, M.S., CCC-SLP
- Speech-Language Pathologist
- Minot, ND
National Provider Identifier
1912446923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1522
- Practice address
- 600 17TH Ave SE
Minot, ND 58701-6756 - Phone
- (701) 857-8761
- NPI assigned
- Feb 23, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 1522 | ND | Primary |
Addresses
Primary practice location
600 17TH Ave SE
Minot, ND 58701-6756
Mailing address
600 17TH Ave SE
Minot, ND 58701-6756
Phone (701) 857-8761
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1522 | ND | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549843200000",
"number": "1912446923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 17TH AVE SE",
"city": "MINOT",
"state": "ND",
"postal_code": "587016756",
"telephone_number": "701-857-8761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 17TH AVE SE",
"city": "MINOT",
"state": "ND",
"postal_code": "587016756",
"telephone_number": "701-857-8761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIG CASALLAS",
"first_name": "KRISTIN",
"middle_name": "MARY",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-23",
"last_updated": "2019-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "ND",
"license": "1522",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minot, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.