Individual provider Active NPI

Patricia K. Williams, SPEECH PATHOLOGIST

  • Speech-Language Pathologist
  • Saint Paul, MN
National Provider Identifier
1780801134
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5708 Issued in MN
Practice address
324 Johnson Pkwy
Saint Paul, MN 55106-6412
Phone
(651) 793-3225
Fax
(651) 793-3213
NPI assigned
Apr 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 5708 MN Primary

Addresses

Primary practice location

324 Johnson Pkwy
Saint Paul, MN 55106-6412

Mailing address

8657 Hillside TRL S
Cottage Grove, MN 55016-3258
Phone (651) 459-0772

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
5708MNMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780801134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8657 HILLSIDE TRL S",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550163258",
            "telephone_number": "651-459-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 JOHNSON PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551066412",
            "telephone_number": "651-793-3225",
            "fax_number": "651-793-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "PATRICIA",
        "middle_name": "K.",
        "name_prefix": "Ms.",
        "credential": "SPEECH PATHOLOGIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "5708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.