Individual provider Active NPI

Sarah Elizabeth Williams, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Lino Lakes, MN
National Provider Identifier
1790943611
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8192 Issued in MN
Practice address
6776 Lake Dr
Suite 220
Lino Lakes, MN 55014-1191
Phone
(651) 784-7007
NPI assigned
May 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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 8192 MN Primary

Addresses

Primary practice location

6776 Lake Dr
Suite 220
Lino Lakes, MN 55014-1191

Mailing address

6776 Lake Dr
Suite 220
Lino Lakes, MN 55014-1191
Phone (651) 784-7007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151029000731 MN Practitioner - Qualified Speech Language Pathologist 4183933344 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
8192MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Occupational Therapy, LLC CurrentSince Aug 29, 2015 Accepting new patients

Locations

6776 Lake Dr
Ste 220
Lino Lakes, MN 55014
Phone (651) 784-7007

Organizations & group practices 2

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": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1790943611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6776 LAKE DR",
            "address_2": "SUITE 220",
            "city": "LINO LAKES",
            "state": "MN",
            "postal_code": "550141191",
            "telephone_number": "651-784-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6776 LAKE DR",
            "address_2": "SUITE 220",
            "city": "LINO LAKES",
            "state": "MN",
            "postal_code": "550141191",
            "telephone_number": "651-784-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "8192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lino Lakes, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; 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.