Active NPI
Clara Petersen
- Speech-Language Pathologist
- Saint Peter, MN
National Provider Identifier
1881470342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 528646
- Practice address
- 830 Sunshine Dr
Ste B
Saint Peter, MN 56082 - Phone
- (507) 934-3573
- NPI assigned
- Aug 31, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 528646 | Primary |
Addresses
Primary practice location
830 Sunshine Dr
Ste B
Saint Peter, MN 56082
Mailing address
830 Sunshine Dr
Ste B
Saint Peter, MN 56082
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693440000000",
"number": "1881470342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "830 SUNSHINE DR",
"address_2": "STE B",
"city": "SAINT PETER",
"state": "MN",
"postal_code": "56082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 SUNSHINE DR",
"address_2": "STE B",
"city": "SAINT PETER",
"state": "MN",
"postal_code": "56082",
"telephone_number": "507-934-3573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSEN",
"first_name": "CLARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-31",
"last_updated": "2023-08-31",
"certification_date": "2023-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": "528646",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Peter, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.