Anna Udenberg

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

10198 Issued in MN

Practice address

2495 Maplewood Dr Ste 313
Maplewood, MN 55109-1985

Phone

(651) 770-8884

NPI assigned

Aug 20, 2019

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

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Family Achievement Center Inc.

  • Occupational Therapist
  • Woodbury, MN
  • NPI 1952411175
  Medicare reassignment

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1053968537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2078 LINCOLN AVE LOWR UNIT",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551051043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 MAPLEWOOD DR STE 313",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091985",
            "telephone_number": "651-770-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDENBERG",
        "first_name": "ANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-20",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "10198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Twin Cities Children'S Anesthesia Dentistry, PLLC
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• Stephanie Marie Tyree-Dahlberg, LMFT
• Sarah Ulman, CCC-SLP
• Ultimate Health Inc
• Ultimate Health Inc
• Ultimate Health Transportation Inc
• Ultimate Healthcare Inc

• Speech-Language Pathologist in Maplewood, MN
• Providers in Maplewood, 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 Aug 20, 2019; 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.