Cecelia Charest Bistner, M.S., CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5001 Issued in MN

Practice address

4910 Saratoga LN N
Plymouth, MN 55442-3014

Phone

(763) 550-1123

Fax

(763) 550-9502

NPI assigned

Apr 18, 2007

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 identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548486178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 SARATOGA LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554423014",
            "telephone_number": "763-550-1123",
            "fax_number": "763-550-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 SARATOGA LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554423014",
            "telephone_number": "763-550-1123",
            "fax_number": "763-550-9502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISTNER",
        "first_name": "CECELIA",
        "middle_name": "CHAREST",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "5001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8G315BI",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA PROVIDER ID",
            "identifier": "4600783",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.