Individual provider Active NPI

Anna Jean Scarborough, M.S-CF-SLP

  • Speech-Language Pathologist
  • Minnetonka, MN
National Provider Identifier
1861967549
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
646 Issued in NE
Practice address
5501 Feltl Rd
Minnetonka, MN 55343-3944
Phone
(952) 746-0222
NPI assigned
Oct 9, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220601001154 OR Practitioner - Qualified Speech Language Pathologist 2860731031 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10233MNMDPhysical Therapist
646NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunbreak Therapy Services, Inc Speech-Language Pathologist CurrentSince Apr 13, 2022 Accepting new patients

Locations

366 N Holly St
Canby, OR 97013
Phone (503) 266-1030

6516 NE Siskiyou St
Portland, OR 97213
Phone (503) 266-1030

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 646 NE Primary

Addresses

NPPES NPI Registry

Primary practice location

5501 Feltl Rd
Minnetonka, MN 55343-3944

Mailing address

5501 Feltl Rd
Minnetonka, MN 55343-3944
Phone (308) 380-7724

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 24, 2019.

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1861967549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 FELTL RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553433944",
            "telephone_number": "308-380-7724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 FELTL RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553433944",
            "telephone_number": "952-746-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCARBOROUGH",
        "first_name": "ANNA",
        "middle_name": "JEAN",
        "credential": "M.S-CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; 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.