Individual provider Active NPI

Alexa Rae-Stevens Hales

  • Speech-Language Pathologist
  • Edina, MN
National Provider Identifier
1821470766
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
10062 Issued in MN
Practice address
3400 W 66TH St Ste 300
Edina, MN 55435-2110
Phone
(619) 246-1884
NPI assigned
Jun 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 19879 CA
Speech-Language Pathologist 235Z00000X 10062 MN Primary

Addresses

Primary practice location

3400 W 66TH St Ste 300
Edina, MN 55435-2110

Mailing address

1406 Edmund Ave
Saint Paul, MN 55104-2407

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200324001721 MN Practitioner - Qualified Speech Language Pathologist 6507294683 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19879CAMDOral and Maxillofacial Surgery (Dentist)
10062MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Clinics CurrentSince Jan 1, 2020 Accepting new patients
Fairview Health Services CurrentSince Jan 1, 2020 Accepting new patients

Locations

3305 Central Park Village Dr
Ste 130
Eagan, MN 55121
Phone (651) 406-8701

3400 W 66th St
Ste 300
Edina, MN 55435
Phone (952) 345-3000

2945 Hazelwood St
Ste 320
Maplewood, MN 55109
Phone (612) 273-1172

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

3305 Central Park Village Dr
#130
Saint Paul, MN 55121

2270 Ford Pkwy
Ste 200
Saint Paul, MN 55116
Phone (651) 696-5000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1435363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1821470766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 EDMUND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W 66TH ST STE 300",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352110",
            "telephone_number": "619-246-1884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALES",
        "first_name": "ALEXA",
        "middle_name": "RAE-STEVENS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-27",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "19879",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "10062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; 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.