Individual provider Active NPI

Katie Ann Malone Kroulik, SLP

  • Speech-Language Pathologist
  • Richfield, MN
National Provider Identifier
1659655272
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8809 Issued in MN
Practice address
7727 Portland Ave
Richfield, MN 55423-4320
Phone
(612) 861-1691
NPI assigned
Sep 30, 2011
Last updated
Sep 30, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2011

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 8809 MN Primary

Addresses

Primary practice location

7727 Portland Ave
Richfield, MN 55423-4320

Mailing address

3527 Pleasant Ave Apt 3
Minneapolis, MN 55408-4349
Phone (612) 221-9687

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

LicenseStateTypeSpecialty
8809MNMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1317340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1659655272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3527 PLEASANT AVE APT 3",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554084349",
            "telephone_number": "612-221-9687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7727 PORTLAND AVE",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554234320",
            "telephone_number": "612-861-1691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROULIK",
        "first_name": "KATIE",
        "middle_name": "ANN MALONE",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-30",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "8809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richfield, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; 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.