Krystle Shane Smith, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

8348 Issued in MN

Practice address

1350 Saint Peter St
Delano, MN 55328-2837

Phone

(763) 688-0353

NPI assigned

Mar 14, 2015

Last updated

Mar 14, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Krystle Shane Baumgarten Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1426291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426291200000",
    "number": "1003209081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15127 81ST ST NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553304558",
            "telephone_number": "763-688-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 SAINT PETER ST",
            "city": "DELANO",
            "state": "MN",
            "postal_code": "553282837",
            "telephone_number": "763-688-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KRYSTLE",
        "middle_name": "SHANE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-14",
        "last_updated": "2015-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "8348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTLE",
            "last_name": "BAUMGARTEN",
            "middle_name": "SHANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Delano, MN
• Providers in Delano, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2015; 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.