Manda Florence Riebel, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

6308 Issued in MN

Practice address

11091 Jason Ave NE Ste 2
Albertville, MN 55301-4703

Phone

(763) 744-4164

Fax

(763) 497-0679

NPI assigned

Nov 23, 2016

Sex

Female

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Aegis Group Practice LLC

  • Physical Therapist
  • Little Falls, MN
  • NPI 1972197382

  Speech-Language Pathologist

  NPD
• Aegis Group Practice LLC

  • Physical Therapist
  • Fort Smith, AR
  • NPI 1417340126

  Speech-Language Pathologist

  NPD
• Aegis Group Practice LLC

  • Physical Therapist
  • Indian Harbour Beach, FL
  • NPI 1932072030

  Speech-Language Pathologist

  NPD

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 17, 2020.

{
    "created_epoch": "1479859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1477096428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4690 LANNON COURT NE",
            "city": "SAINT MICHAEL",
            "state": "MN",
            "postal_code": "55376",
            "telephone_number": "763-913-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11091 JASON AVE NE STE 2",
            "city": "ALBERTVILLE",
            "state": "MN",
            "postal_code": "553014703",
            "telephone_number": "763-744-4164",
            "fax_number": "763-497-0679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEBEL",
        "first_name": "MANDA",
        "middle_name": "FLORENCE",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-23",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "6308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Carl Peterson, P.T.A.
• Hailey Peterson
• Lauren Kristine Phipps, D.D.S.
• Heather Lynn Pokrzywinski, PA-C
• Zainab Ramoni
• Heidi Sawdey, D.C.
• Meaghan Schmitt
• Mary Schroter, MD
• Rachel Schuler Borer, PT
• Kathleeen Schultz

• All providers in Albertville, MN
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; 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.