Active NPI
Suzanne Carl, SPEECH PATHOLOGIST
- Speech-Language Pathologist
- St. Paul, MN
National Provider Identifier
1124419940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 00808014
- Practice address
- 360 Colborne Avenue
St. Paul, MN 55102 - Phone
- (651) 767-8189
- NPI assigned
- Feb 16, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 00808014 | MN | Primary |
| Speech-Language Pathologist | 235Z00000X | 233910 | MN |
Addresses
Primary practice location
360 Colborne Avenue
St. Paul, MN 55102
Mailing address
765 Lower Colonial Dr
Mendota Heights, MN 55118-2713
Phone (651) 455-4102
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 |
|---|---|---|---|
| 00808014 | MN | MD | Speech-Language Pathologist |
| 233910 | MN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424044800000",
"number": "1124419940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "765 LOWER COLONIAL DR",
"city": "MENDOTA HEIGHTS",
"state": "MN",
"postal_code": "551182713",
"telephone_number": "651-455-4102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 COLBORNE AVENUE",
"city": "ST. PAUL",
"state": "MN",
"postal_code": "55102",
"telephone_number": "651-767-8189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARL",
"first_name": "SUZANNE",
"credential": "SPEECH PATHOLOGIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-16",
"last_updated": "2015-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MN",
"license": "00808014",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MN",
"license": "233910",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St. Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.