Individual provider Active NPI

Rochelle Elizabeth Loomis, MS, CCC-SLP

  • Speech-Language Pathologist
  • Maple Grove, MN
National Provider Identifier
1417306457
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP009297 Issued in GA
Practice address
7767 Elm Creek Blvd N
Suite 100
Maple Grove, MN 55369-7041
Phone
(763) 416-8715
NPI assigned
Jun 9, 2016
Last updated
Jun 9, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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 8240 MN
Speech-Language Pathologist 235Z00000X SLP009297 GA Primary

Addresses

Primary practice location

7767 Elm Creek Blvd N
Suite 100
Maple Grove, MN 55369-7041

Mailing address

9573 Alvarado LN N
Maple Grove, MN 55311-1151
Phone (612) 719-5318

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
SLP009297GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Alpha Pediatric Therapy LLC Speech-Language Pathologist CurrentSince Oct 29, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465430400000",
    "number": "1417306457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9573 ALVARADO LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553111151",
            "telephone_number": "612-719-5318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7767 ELM CREEK BLVD N",
            "address_2": "SUITE 100",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697041",
            "telephone_number": "763-416-8715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOOMIS",
        "first_name": "ROCHELLE",
        "middle_name": "ELIZABETH",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2016-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "8240",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP009297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; 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.