Individual provider Active NPI

Meredith Richards, CCC-SLP

  • Speech-Language Pathologist
  • Saint Louis Park, MN
National Provider Identifier
1770104036
Registry record updated Apr 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
4209 Princeton Ave
Saint Louis Park, MN 55416-3230
Phone
(612) 790-7970
NPI assigned
Apr 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2020

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

4209 Princeton Ave
Saint Louis Park, MN 55416-3230

Mailing address

4209 Princeton Ave
Saint Louis Park, MN 55416-3230
Phone (612) 790-7970

Other names 1

  • Meredith Lewis Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
10444MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Meredith Richards Speech Therapy 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": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588032000000",
    "number": "1770104036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4209 PRINCETON AVE",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554163230",
            "telephone_number": "612-790-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4209 PRINCETON AVE",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554163230",
            "telephone_number": "612-790-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "MEREDITH",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-28",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEREDITH",
            "last_name": "LEWIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2020; 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.