Individual provider Active NPI

Susan E. Krueger, M.S., SLP-CCC

  • Speech-Language Pathologist
  • Bozeman, MT
National Provider Identifier
1366978223
Registry record updated Nov 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP-SP-LIC-8765 Issued in MT
Practice address
720 Stoneridge Dr
Suite #1
Bozeman, MT 59718-7032
Phone
(406) 556-9853
NPI assigned
May 11, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP-SP-TMP-6292 MT
Speech-Language Pathologist 235Z00000X SLP-SP-LIC-8765 MT Primary

Addresses

Primary practice location

720 Stoneridge Dr
Suite #1
Bozeman, MT 59718-7032

Mailing address

1303 Driftwood Dr
Bozeman, MT 59715-9517
Phone (406) 209-5787

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 Science

State licenses

LicenseStateTypeSpecialty
SLP-SP-LIC-8765MTMDSpeech-Language Pathologist
SLP-SP-TMP-6292MTMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606435200000",
    "number": "1366978223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 DRIFTWOOD DR",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597159517",
            "telephone_number": "406-209-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 STONERIDGE DR",
            "address_2": "SUITE #1",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597187032",
            "telephone_number": "406-556-9853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "SUSAN",
        "middle_name": "E.",
        "credential": "M.S., SLP-CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2020-11-27",
        "certification_date": "2020-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MT",
            "license": "SLP-SP-TMP-6292",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MT",
            "license": "SLP-SP-LIC-8765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.

Verify at the official NPI Registry.