Active NPI
Marsha Sullivan-Jameton, CCC-SLP
- Speech-Language Pathologist
- St. Paul, MN
National Provider Identifier
1386722734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 65
- Practice address
- 295 Phalen Blvd.
St. Paul, MN 55485-3969 - Phone
- (651) 254-3200
- NPI assigned
- Nov 2, 2006
- 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 | 65 | NE | Primary |
Addresses
Primary practice location
295 Phalen Blvd.
St. Paul, MN 55485-3969
Mailing address
985450 Nebraska Med Ctr
Omaha, NE 68198-5450
Phone (402) 559-8943
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025289000 | Medicaid | NE |
Other names 1
- Marsha Sullivan
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65 | NE | MD | Audiologist-Hearing Aid Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511827200000",
"number": "1386722734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "985450 NEBRASKA MED CTR",
"city": "OMAHA",
"state": "NE",
"postal_code": "681985450",
"telephone_number": "402-559-8943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "295 PHALEN BLVD.",
"city": "ST. PAUL",
"state": "MN",
"postal_code": "554853969",
"telephone_number": "651-254-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN-JAMETON",
"first_name": "MARSHA",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-02",
"last_updated": "2017-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NE",
"license": "65",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025289000",
"state": "NE"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARSHA",
"last_name": "SULLIVAN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in St. Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.