Active NPI
Emily Waldoch
- Speech-Language Pathologist
- Wyoming, MN
National Provider Identifier
1497018501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 8628
- Practice address
- 21900 Typo Creek Dr NE
Wyoming, MN 55092-9451 - Phone
- (651) 982-1906
- NPI assigned
- Jun 22, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 8628 | MN | Primary |
Addresses
Primary practice location
21900 Typo Creek Dr NE
Wyoming, MN 55092-9451
Mailing address
6100 210TH St N
Forest Lake, MN 55025-9617
Phone (651) 982-8100
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8628 | MN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Forest Lake Area Schools #831 | Past | 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.
-
- Local Education Agency (LEA)
- Forest Lake, MN
- NPI 1407939747
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765411200000",
"number": "1497018501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6100 210TH ST N",
"city": "FOREST LAKE",
"state": "MN",
"postal_code": "550259617",
"telephone_number": "651-982-8100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21900 TYPO CREEK DR NE",
"city": "WYOMING",
"state": "MN",
"postal_code": "550929451",
"telephone_number": "651-982-1906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDOCH",
"first_name": "EMILY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-22",
"last_updated": "2025-12-11",
"certification_date": "2025-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MN",
"license": "8628",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wyoming, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.