Carrie Latvala Jerylo, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

6292 Issued in MN

Practice address

13750 Crosstown Dr NW
Suite 310
Andover, MN 55304-5853

Phone

(763) 755-4275

Fax

(763) 755-4261

NPI assigned

Jan 30, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Carrie Jean Latvala Former name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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.

• Family Speech & Therapy Services, LLC

  • Speech-Language Pathologist
  • Andover, MN
  • NPI 1235285966
  Medicare reassignment

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770629297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14060 AZTEC ST NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553047443",
            "telephone_number": "763-422-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13750 CROSSTOWN DR NW",
            "address_2": "SUITE 310",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553045853",
            "telephone_number": "763-755-4275",
            "fax_number": "763-755-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERYLO",
        "first_name": "CARRIE",
        "middle_name": "LATVALA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "6292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "131G3JE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP34823",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "46-00854",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "LATVALA",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Susan Lynn Murdy Jaeger, M.S.
• Rose Ellen Janecke, MA, CCC-SLP
• Molli Rose Jannette, PHARM.D.
• Barbara Jo January, RN
• Christine Marie Jensen, PAC
• Jacqueline Jeziorski, CFY - SLP
• Ellen Johnson, OTR/L
• Jaidyn Johnson, OTR/L
• Mikkayla Mae Johnson, OT
• Bennett Jones, L.I.C.S.W.

• Speech-Language Pathologist in Andover, MN
• Providers in Andover, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.