Individual provider Active NPI

Cynthia E Niederjohn, M.A., CCC SLP

  • Speech-Language Pathologist
  • Saint Paul, MN
National Provider Identifier
1174792832
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8161 Issued in MN
Practice address
561 7TH St W
Saint Paul, MN 55102-3009
Phone
(651) 225-4558
Fax
(651) 225-9474
NPI assigned
Feb 27, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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 8161 MN Primary

Addresses

Primary practice location

561 7TH St W
Saint Paul, MN 55102-3009

Mailing address

561 7TH St W
Saint Paul, MN 55102-3009
Phone (651) 225-4558

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
8161MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Speech and Language Specialists LLC Speech-Language Pathologist PastSince Dec 12, 2015 Accepting new patients
Associated Speech and Language Past Accepting new patients

Organizations & group practices 2

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": "1204070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1174792832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 7TH ST W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551023009",
            "telephone_number": "651-225-4558",
            "fax_number": "651-225-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 7TH ST W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551023009",
            "telephone_number": "651-225-4558",
            "fax_number": "651-225-9474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEDERJOHN",
        "first_name": "CYNTHIA",
        "middle_name": "E",
        "credential": "M.A., CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-27",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "8161",
            "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 Feb 27, 2008; 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.