Active NPI
Christine M Garry, SLP
- Speech-Language Pathologist
- Excelsior, MN
National Provider Identifier
1124246384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 6044
- Practice address
- 464 2ND St Ste 106
Excelsior, MN 55331-2108 - Phone
- (952) 401-4242
- NPI assigned
- Apr 23, 2007
- 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 | 6044 | MN | Primary |
Addresses
Primary practice location
464 2ND St Ste 106
Excelsior, MN 55331-2108
Mailing address
6683 Pointe Lake Lucy
Chanhassen, MN 55317-8433
Phone (952) 401-4242
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6044 | MN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Madison Center | Speech-Language Pathologist | Past | Accepting new patients |
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.
-
- Speech-Language Pathologist
- Excelsior, MN
- NPI 1083832158
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264723200000",
"number": "1124246384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6683 POINTE LAKE LUCY",
"city": "CHANHASSEN",
"state": "MN",
"postal_code": "553178433",
"telephone_number": "952-401-4242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "464 2ND ST STE 106",
"city": "EXCELSIOR",
"state": "MN",
"postal_code": "553312108",
"telephone_number": "952-401-4242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARRY",
"first_name": "CHRISTINE",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-23",
"last_updated": "2010-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MN",
"license": "6044",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Excelsior, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.