Individual provider Active NPI

Carolyn Ann Lundell, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Saint Paul, MN
National Provider Identifier
1174768782
Registry record updated Nov 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8148 Issued in MN
Practice address
867 Cleveland Ave S
Apt. 12
Saint Paul, MN 55116-1895
Phone
(651) 492-9425
NPI assigned
Dec 10, 2008
Last updated
Nov 23, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2010

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 8148 MN Primary

Addresses

Primary practice location

867 Cleveland Ave S
Apt. 12
Saint Paul, MN 55116-1895

Mailing address

8757 E Dry Creek Rd
Unit 1524
Centennial, CO 80112-2789
Phone (651) 815-3300

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
8148MNMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290470400000",
    "number": "1174768782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8757 E DRY CREEK RD",
            "address_2": "UNIT 1524",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801122789",
            "telephone_number": "651-815-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "867 CLEVELAND AVE S",
            "address_2": "APT. 12",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161895",
            "telephone_number": "651-492-9425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDELL",
        "first_name": "CAROLYN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-10",
        "last_updated": "2010-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "8148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.

Verify at the official NPI Registry.