Individual provider Active NPI

Heather Jan Schultz, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Park Rapids, MN
National Provider Identifier
1902332000
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2016022801 Issued in MN
Practice address
Telemedicine Services
501 Eastern Ave S
Park Rapids, MN 56470-5647
Phone
(319) 471-8328
NPI assigned
May 10, 2017
Last updated
Nov 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

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 2016022801 MN Primary

Addresses

Primary practice location

Telemedicine Services
501 Eastern Ave S
Park Rapids, MN 56470-5647

Mailing address

501 Eastern Ave S
Park Rapids, MN 56470-1757
Phone (319) 471-8328

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210611000143 MN Practitioner - Qualified Speech Language Pathologist 4284034307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Regional Health CenterGroup PAC ID 2062326820, 190 clinicians

Practice addresses (Care Compare)

1103 1St St E
Park Rapids, MN 56470-1879
Phone (218) 732-6300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
26023CAMDMarriage & Family Therapist
2016022801MNMDSpeech-Language Pathologist
10244MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Regional Health Center CurrentSince Jul 12, 2021 Accepting new patients
St. Marys Regional Health Center Current Accepting new patients
St Mary's Regional Health Center CurrentSince Jul 12, 2021 Accepting new patients

Locations

1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

1103 1st St E
Park Rapids, MN 56470
Phone (218) 732-0542

Organizations & group practices 3

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": "1494374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1902332000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 EASTERN AVE S",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564701757",
            "telephone_number": "319-471-8328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TELEMEDICINE SERVICES",
            "address_2": "501 EASTERN AVE S",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564705647",
            "telephone_number": "319-471-8328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "HEATHER",
        "middle_name": "JAN",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-10",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "2016022801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.