Individual provider Active NPI

Sommer Angeline Kopff, CCC-SLP

  • Speech-Language Pathologist
  • Maplewood, MN
National Provider Identifier
1396434247
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
528343
Practice address
2495 Maplewood Dr W
Suite 313
Maplewood, MN 55109
Phone
(651) 770-8884
NPI assigned
May 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2023

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 528343 Primary

Addresses

Primary practice location

2495 Maplewood Dr W
Suite 313
Maplewood, MN 55109

Mailing address

930 Lincoln St NW
Maple Lake, MN 55358-2489

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

NPI Registry JSON

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

{
    "created_epoch": "1683244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1396434247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 LINCOLN ST NW",
            "city": "MAPLE LAKE",
            "state": "MN",
            "postal_code": "553582489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 MAPLEWOOD DR W",
            "address_2": "SUITE 313",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "55109",
            "telephone_number": "651-770-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPFF",
        "first_name": "SOMMER",
        "middle_name": "ANGELINE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-05",
        "last_updated": "2023-05-05",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "528343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; 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.