Individual provider Active NPI

Andrea Michelle Vosberg, MA, CCC-SLP

  • Speech-Language Pathologist
  • Watertown, SD
National Provider Identifier
1043541691
Registry record updated Apr 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
215 S Maple
Watertown, SD 57201-4316
Phone
(605) 886-5777
Fax
(605) 886-0790
NPI assigned
Jan 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2020

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 Primary

Addresses

Primary practice location

215 S Maple
Watertown, SD 57201-4316

Mailing address

1628 8TH St NE
Watertown, SD 57201-6903
Phone (605) 881-5669

Other practice location 1

901 14th Ave NE
Watertown, SD 57201-6817
Phone (605) 882-3084

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200429000730 SD Practitioner - Qualified Speech Language Pathologist 8022448398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Adio/Pennsylvania Institute of Straight Chiropractic, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caring Edge Op LLCGroup PAC ID 6406114131, 36 clinicians

Practice addresses (Care Compare)

901 14TH Ave NE
Watertown, SD 57201-6817
Phone (605) 954-4264

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Caring Edge Op LLC CurrentSince Apr 1, 2020 Accepting new patients

Locations

1950 E 4th St
Pierre, SD 57501
Phone (605) 494-3400

Organizations & group practices 1

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": "1264032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1043541691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 8TH ST NE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572016903",
            "telephone_number": "605-881-5669",
            "fax_number": "605-886-0790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S MAPLE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572014316",
            "telephone_number": "605-886-5777",
            "fax_number": "605-886-0790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 14th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "SD",
            "postal_code": "572016817",
            "country_code": "US",
            "telephone_number": "605-882-3084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VOSBERG",
        "first_name": "ANDREA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-21",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.