Individual provider Active NPI

Madison Marie Mueller, SLP

  • Speech-Language Pathologist
  • Shoreview, MN
National Provider Identifier
1477145209
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
518049 Issued in MN
Practice address
490 Highway 96 W Ste 300
Shoreview, MN 55126-1961
Phone
(651) 451-3016
Fax
(651) 481-7040
NPI assigned
Feb 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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 518049 MN Primary

Addresses

Primary practice location

490 Highway 96 W Ste 300
Shoreview, MN 55126-1961

Mailing address

490 Highway 96 W Ste 300
Shoreview, MN 55126-1961
Phone (651) 451-3016

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220331000772 MN Practitioner - Qualified Speech Language Pathologist 4284020223 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Outpatient Services, LLC Speech-Language Pathologist CurrentSince Mar 1, 2022 Accepting new patients
Fairview Express Care CurrentSince Mar 1, 2022 Accepting new patients
Fairview Express Care CurrentSince Mar 1, 2022 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

3305 Central Park Village Dr
Ste 130
Eagan, MN 55121
Phone (651) 406-8701

2945 Hazelwood St
Ste 320
Maplewood, MN 55109
Phone (612) 273-1172

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

3305 Central Park Village Dr
#130
Saint Paul, MN 55121

1825 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1477145209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 HIGHWAY 96 W STE 300",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551261961",
            "telephone_number": "651-451-3016",
            "fax_number": "651-481-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 HIGHWAY 96 W STE 300",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551261961",
            "telephone_number": "651-451-3016",
            "fax_number": "651-481-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "MADISON",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-02-03",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "518049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreview, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.