Active NPI
Julia Middendorf Anderson, SLP
- Speech-Language Pathologist
- Council Bluffs, IA
National Provider Identifier
1184245854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 01638
- Practice address
- 3000 Risen Son Blvd
Council Bluffs, IA 51503-1911 - Phone
- (712) 366-9655
- NPI assigned
- May 4, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 01638 | IA | Primary |
Addresses
Primary practice location
3000 Risen Son Blvd
Council Bluffs, IA 51503-1911
Mailing address
2804 Scenic PL
West Des Moines, IA 50265-6436
Phone (515) 371-5133
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 |
|---|---|---|---|
| 01638 | IA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588550400000",
"number": "1184245854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2804 SCENIC PL",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502656436",
"telephone_number": "515-371-5133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 RISEN SON BLVD",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515031911",
"telephone_number": "712-366-9655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JULIA",
"middle_name": "MIDDENDORF",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-04",
"last_updated": "2020-05-04",
"certification_date": "2020-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IA",
"license": "01638",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Council Bluffs, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.