Active NPI
Kaela Feddersen, M.S.
- Speech-Language Pathologist
- Waconia, MN
National Provider Identifier
1700418241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 9346 Oak Ave
Waconia, MN 55387-9422 - Phone
- (712) 330-7349
- NPI assigned
- Feb 12, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 528939 | MN | |
| Speech-Language Pathologist | 235Z00000X | CO | Primary |
Addresses
Primary practice location
9346 Oak Ave
Waconia, MN 55387-9422
Mailing address
1832 Spring Creek Dr
Carver, MN 55315-4573
Phone (712) 330-7349
Other names 1
- Kaela Delperdang
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunnydays Therapy Inc | Speech-Language Pathologist | Current | Accepting new patients |
Locations
15265 Minnetonka Blvd
Minnetonka, MN 55345
9346 Oak Ave
Waconia, MN 55387
Phone (952) 442-5812
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": "1581465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719878400000",
"number": "1700418241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1832 SPRING CREEK DR",
"city": "CARVER",
"state": "MN",
"postal_code": "553154573",
"telephone_number": "712-330-7349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9346 OAK AVE",
"city": "WACONIA",
"state": "MN",
"postal_code": "553879422",
"telephone_number": "712-330-7349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEDDERSEN",
"first_name": "KAELA",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-12",
"last_updated": "2024-07-02",
"certification_date": "2024-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MN",
"license": "528939",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CO",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KAELA",
"last_name": "DELPERDANG",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Waconia, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.