Individual provider Active NPI

Sandra P Ewel, MA, CCC-SLP

  • Speech-Language Pathologist
  • Mankato, MN
National Provider Identifier
1346897014
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6004 Issued in MN
Practice address
149 Fairway Dr
Mankato, MN 56001-3139
Phone
(507) 381-3078
NPI assigned
Aug 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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 6004 MN Primary

Addresses

Primary practice location

149 Fairway Dr
Mankato, MN 56001-3139

Mailing address

149 Fairway Dr
Mankato, MN 56001-3139
Phone (507) 381-3078

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6004MNMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1346897014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 FAIRWAY DR",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560013139",
            "telephone_number": "507-381-3078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 FAIRWAY DR",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560013139",
            "telephone_number": "507-381-3078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWEL",
        "first_name": "SANDRA",
        "middle_name": "P",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-19",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; 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.