Individual provider Active NPI

Molly Coyne, CCC-SLP

  • Speech-Language Pathologist
  • Burnsville, MN
National Provider Identifier
1861975781
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
10176 Issued in MN
Practice address
201 E Nicollet Blvd
Burnsville, MN 55337-5799
Phone
(952) 892-2121
Fax
(952) 892-2405
NPI assigned
Sep 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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 10176 MN Primary

Addresses

Primary practice location

201 E Nicollet Blvd
Burnsville, MN 55337-5799

Mailing address

2065 Douglas LN
Saint Paul, MN 55110-3809
Phone (609) 304-9510

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
10176MNMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1536278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1861975781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2065 DOUGLAS LN",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551103809",
            "telephone_number": "609-304-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E NICOLLET BLVD",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553375799",
            "telephone_number": "952-892-2121",
            "fax_number": "952-892-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COYNE",
        "first_name": "MOLLY",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-07",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "10176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; 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.