Melissa A Buelow, SLPCCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7654 Issued in MN

Practice address

3305 Central Park Village Dr
Eagan, MN 55121-7707

Phone

(952) 285-2840

Fax

(952) 285-2830

NPI assigned

Aug 9, 2005

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 names 1

• Melissa A Boehnke Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1861493322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 OAK RIDGE RD",
            "address_2": "APT 328",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553054854",
            "telephone_number": "952-237-9148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 CENTRAL PARK VILLAGE DR",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551217707",
            "telephone_number": "952-285-2840",
            "fax_number": "952-285-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUELOW",
        "first_name": "MELISSA",
        "middle_name": "A",
        "credential": "SLPCCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "7654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "BOEHNKE",
            "middle_name": "A",
            "credential": "SLPCCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tamara Bruns, CPHT
• Takiya Charissa Bryant
• Max Bubar, M.T.
• Sarah Beth Carlson Buckley, MD
• Eleanor-Irene B Bucu, MD
• Karen Buendorf
• Clifford James Buhl, PSYD, LP
• Shawn Michael Bulgatz, LMFT
• Becky Jo Burdick, PA-C
• Amelia L Burgess, M.D.

• Speech-Language Pathologist in Eagan, MN
• Providers in Eagan, 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 21, 2022; 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.