| Red Door Pediatric Therapy | |
|
2625 N 19th St Bismarck ND 58503-0574 | |
| (701) 222-3175 | |
| (701) 222-3186 |
| Full Name | Red Door Pediatric Therapy |
|---|---|
| Speciality | Speech-Language Pathologist |
| Location | 2625 N 19th St, Bismarck, North Dakota |
| Authorized Official Name and Position | Tia-lee Whitted (FINANCIAL SPECIALIST) |
| Authorized Official Contact | 7012145617 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Red Door Pediatric Therapy 2625 N 19th St Bismarck ND 58503-0574 Ph: (701) 222-3175 | Red Door Pediatric Therapy 2625 N 19th St Bismarck ND 58503-0574 Ph: (701) 222-3175 |
| NPI Number | 1639257033 |
|---|---|
| Provider Enumeration Date | 11/02/2006 |
| Last Update Date | 09/22/2021 |
| Certification Date | 09/22/2021 |
| Medicare PECOS PAC ID | 9739571647 |
|---|---|
| Medicare Enrollment ID | O20220126000470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639257033 | NPI | - | NPPES |
| 1450786 | Medicaid | ND | |
| 1451283 | Medicaid | ND | |
| 1454142 | Medicaid | ND | |
| 1467615 | Medicaid | ND | |
| 1470224 | Medicaid | ND | |
| 1474097 | Medicaid | ND | |
| 1477997 | Medicaid | ND | |
| 1459139 | Medicaid | ND | |
| 1463121 | Medicaid | ND | |
| 1452036 | Medicaid | ND | |
| 1452040 | Medicaid | ND | |
| 1454300 | Medicaid | ND | |
| 1464388 | Medicaid | ND | |
| 1466867 | Medicaid | ND | |
| 1476591 | Medicaid | ND | |
| 1480013 | Medicaid | ND | |
| 1480766 | Medicaid | ND | |
| 1480833 | Medicaid | ND | |
| 1481160 | Medicaid | ND | |
| 1454835 | Medicaid | ND | |
| 1454897 | Medicaid | ND | |
| 1465117 | Medicaid | ND | |
| 1468739 | Medicaid | ND | |
| 1452184 | Medicaid | ND | |
| 1461503 | Medicaid | ND | |
| 1461975 | Medicaid | ND | |
| 1465122 | Medicaid | ND | |
| 1468069 | Medicaid | ND | |
| 1459816 | Medicaid | ND | |
| 1464384 | Medicaid | ND | |
| 1466654 | Medicaid | ND | |
| 1469164 | Medicaid | ND | |
| 1477918 | Medicaid | ND | |
| 1477950 | Medicaid | ND | |
| 1469028 | Medicaid | ND | |
| 1477752 | Medicaid | ND |
| Provider Name | Alyssa Turner-strong |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1588262778 PECOS PAC ID: 2365854163 Enrollment ID: I20210125001534 |
| Provider Name | Abby M Fisher |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1699350926 PECOS PAC ID: 0648677401 Enrollment ID: I20210921001669 |
| Provider Name | Crystal Baerwald |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1588144539 PECOS PAC ID: 1153660030 Enrollment ID: I20220228000302 |
| Provider Name | Hannah E Scott |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1487179578 PECOS PAC ID: 2163801234 Enrollment ID: I20220620001885 |
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