Angie Thompson

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

10491 Issued in MN

Practice address

6776 Lake Dr Ste 220
Lino Lakes, MN 55014-1192

Phone

(651) 784-7007

NPI assigned

Aug 5, 2020

Last updated

Aug 5, 2020By the provider in NPPES

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

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advance Speech Therapy, LLC

  dba Advance Therapy

  • Speech-Language Pathologist
  • Lino Lakes, MN
  • NPI 1215144654
  Medicare reassignment NPD
• Advance Occupational Therapy, LLC

  dba Advance Therapy

  • Occupational Therapist
  • Lino Lakes, MN
  • NPI 1174730899
  NPD
• Advance Therapy

  • Speech-Language Pathologist
  • Lino Lakes, MN
  • NPI 1043644784
  NPD (past)

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

{
    "created_epoch": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1376153346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6139 PINE ST",
            "city": "LINO LAKES",
            "state": "MN",
            "postal_code": "550142013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6776 LAKE DR STE 220",
            "city": "LINO LAKES",
            "state": "MN",
            "postal_code": "550141192",
            "telephone_number": "651-784-7007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2555 County Road E E Ste 102",
            "address_purpose": "LOCATION",
            "city": "White Bear Lake",
            "state": "MN",
            "postal_code": "551104906",
            "country_code": "US",
            "telephone_number": "651-683-2953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "ANGIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-05",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "10491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Michael Terhaar
• Mai Ntshiab Thao, MA, LMFT
• The Circle of Healing Arts
• Therapy Partners, Inc.
• Thomas Tardif Performance Solutions (Resonance Performance Solutions)
• McKay Tilton, MA, LPCC, LADC
• Timberwolf Anesthesia SC
• Alaina Jean Tolzmann
• Michael Charles Tressler, M.D
• Tonya Lee Van Ee, RN

• Speech-Language Pathologist in Lino Lakes, MN
• Providers in Lino Lakes, 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 Aug 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.