Individual provider Active NPI

Karin Kongsjord Nikula, EDD/CCC-SLP

  • Speech-Language Pathologist
  • Richfield, MN
National Provider Identifier
1396916763
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6477 Issued in MN
Practice address
7727 Portland Ave
Richfield, MN 55423-4320
Phone
(612) 455-0304
NPI assigned
Mar 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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 6477 MN Primary

Addresses

Primary practice location

7727 Portland Ave
Richfield, MN 55423-4320

Mailing address

442 High Point Curv S
Maplewood, MN 55119-6753
Phone (651) 735-6689

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

LicenseStateTypeSpecialty
6477MNMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205366400000",
    "number": "1396916763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 HIGH POINT CURV S",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551196753",
            "telephone_number": "651-735-6689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7727 PORTLAND AVE",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554234320",
            "telephone_number": "612-455-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKULA",
        "first_name": "KARIN",
        "middle_name": "KONGSJORD",
        "name_prefix": "Ms.",
        "credential": "EDD/CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-13",
        "last_updated": "2008-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "6477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richfield, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; 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.