Individual provider Active NPI

Nancy Suelflow, CCC-SLP

  • Speech-Language Pathologist
  • Custer, SD
National Provider Identifier
1619082807
Registry record updated Feb 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
409 Young Dr
Custer, SD 57730-1200
Phone
(605) 440-0016
Fax
(605) 673-3517
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2010

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 Primary

Addresses

Primary practice location

409 Young Dr
Custer, SD 57730-1200

Mailing address

409 Young Dr
Custer, SD 57730-1200
Phone (605) 440-0016

Other identifiers 1

IdentifierTypeStateIssuer
5835283MedicaidSD

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

Practice roles

OrganizationSpecialtyStatusNew patients
Word of Mouth, Inc Speech-Language Pathologist Current 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265068800000",
    "number": "1619082807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 YOUNG DR",
            "city": "CUSTER",
            "state": "SD",
            "postal_code": "577301200",
            "telephone_number": "605-440-0016",
            "fax_number": "605-673-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 YOUNG DR",
            "city": "CUSTER",
            "state": "SD",
            "postal_code": "577301200",
            "telephone_number": "605-440-0016",
            "fax_number": "605-673-3517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUELFLOW",
        "first_name": "NANCY",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2010-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5835283",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Custer, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2010; 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.