Individual provider Active NPI

Angela Stromberg, CCC-SLP

  • Speech-Language Pathologist
  • Baxter, MN
National Provider Identifier
1508275454
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
9126 Issued in MN
Practice address
14387 Edgewood Dr
Baxter, MN 56425-8460
Phone
(218) 454-5183
NPI assigned
Aug 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 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 9126 MN Primary

Addresses

Primary practice location

14387 Edgewood Dr
Baxter, MN 56425-8460

Mailing address

14387 Edgewood Dr
Baxter, MN 56425-8460
Phone (218) 454-5183

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210521001211 MN Practitioner - Qualified Speech Language Pathologist 2567861651 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10352MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Therapy Partners, Inc. Speech-Language Pathologist CurrentSince Jun 26, 2025 Accepting new patients
Grazia, LLC Speech-Language Pathologist Past Accepting new patients

Locations

108 Doctors Park
Saint Cloud, MN 56303
Phone (320) 774-3915

419 Atlantic Ave
Thief River Falls, MN 56701
Phone (218) 416-1482

Organizations & group practices 2

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": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1508275454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14387 EDGEWOOD DR",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258460",
            "telephone_number": "218-454-5183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14387 EDGEWOOD DR",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258460",
            "telephone_number": "218-454-5183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROMBERG",
        "first_name": "ANGELA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-05",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "9126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxter, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.