NPIMap

Individual provider Active NPI

Caroline Ann Clause, CCC-SLP

  • Speech-Language Pathologist
  • Victoria, MN
National Provider Identifier
1649784976
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
9725 Issued in MN
Practice address
1772 Steiger Lake LN
Victoria, MN 55386-7723
Phone
(952) 443-9888
Fax
(952) 443-9804
NPI assigned
Nov 22, 2017
Last updated
Jun 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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 9725 MN Primary

Addresses

Primary practice location

1772 Steiger Lake LN
Victoria, MN 55386-7723

Mailing address

1772 Steiger Lake LN
Victoria, MN 55386-7723
Phone (952) 443-9888

Other practice location 1

8758 Egan Dr
Savage, MN 55378-2561
Phone (952) 443-9888

Other identifiers 7

IdentifierTypeStateIssuer
001442700MedicaidMN
565581028804OtherMNPREFERRED ONE
16154051OtherMNPT CARE
017J6KIOtherMNBCBS
76842OtherMNHEALTH PARTNERS
1311578OtherMNARAZ/AMERICA'S PPO/CIGNA
169036OtherMNUCARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171222001227 MN Practitioner - Qualified Speech Language Pathologist 9335407204 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kid Talk Inc Speech-Language Pathologist Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1511308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1649784976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1772 STEIGER LAKE LN",
            "city": "VICTORIA",
            "state": "MN",
            "postal_code": "553867723",
            "telephone_number": "952-443-9888",
            "fax_number": "952-443-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1772 STEIGER LAKE LN",
            "city": "VICTORIA",
            "state": "MN",
            "postal_code": "553867723",
            "telephone_number": "952-443-9888",
            "fax_number": "952-443-9804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8758 Egan Dr",
            "address_purpose": "LOCATION",
            "city": "Savage",
            "state": "MN",
            "postal_code": "553782561",
            "country_code": "US",
            "telephone_number": "952-443-9888",
            "fax_number": "952-443-9804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLAUSE",
        "first_name": "CAROLINE",
        "middle_name": "ANN",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-22",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "9725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001442700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "565581028804",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT CARE",
            "identifier": "16154051",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "017J6KI",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "76842",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ/AMERICA'S PPO/CIGNA",
            "identifier": "1311578",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "169036",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.