Marcie B Kloosterman, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

22004143A Issued in IN

Practice address

23375 Amber Valley Dr
South Bend, IN 46628-8139

Phone

(219) 688-2348

NPI assigned

Sep 10, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Marcie B Todd Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1284076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284076800000",
    "number": "1447567599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23375 AMBER VALLEY DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466288139",
            "telephone_number": "219-688-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23375 AMBER VALLEY DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466288139",
            "telephone_number": "219-688-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOOSTERMAN",
        "first_name": "MARCIE",
        "middle_name": "B",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-10",
        "last_updated": "2010-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22004143A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCIE",
            "last_name": "TODD",
            "middle_name": "B",
            "credential": "SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel Wayne Kletzing, MD
• Alexis Kline
• Randall I Kline, D.P.M.
• Sharon K Klingerman, N.P.
• Edward F Klodzinski, LMHC
• Klopenstine Family Dentistry PC
• Geoffrey Allen Klopenstine, D.D.S.
• Channah C Klor, FNP-BC
• Rachael Klowetter
• Kathleen B Kmitta, MS

• Speech-Language Pathologist in South Bend, IN
• Providers in South Bend, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; 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.