Bobby Jo Mineheine, CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

8091 Issued in MN

Practice address

530 East Second St
Polinsky Medical Rehab Ctr
Duluth, MN 55805

Phone

(218) 786-5360

NPI assigned

Oct 22, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1215237433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 EAST SECOND ST",
            "address_2": "POLINSKY MEDICAL REHAB CTR",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-786-5360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 EAST SECOND ST",
            "address_2": "POLINSKY MEDICAL REHAB CTR",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-786-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINEHEINE",
        "first_name": "BOBBY",
        "middle_name": "JO",
        "credential": "CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-22",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "8091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Duluth, MN
• Providers in Duluth, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; 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.