Robert Brady Grider, MS/CCC-SP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5042 Issued in MN

Practice address

915 Mainstreet
Hopkins, MN 55343-7565

Phone

(952) 929-1981

Fax

(952) 206-7731

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

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.

• Minnetonka Pediatric Therapy Center, LLC

  • Speech-Language Pathologist
  • Plymouth, MN
  • NPI 1891998035
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1902905599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4219",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553430494",
            "telephone_number": "952-929-1981",
            "fax_number": "952-206-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 MAINSTREET",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553437565",
            "telephone_number": "952-929-1981",
            "fax_number": "952-206-7731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 12th Ave N",
            "address_purpose": "LOCATION",
            "city": "Hopkins",
            "state": "MN",
            "postal_code": "553437381",
            "country_code": "US",
            "telephone_number": "952-929-1981",
            "fax_number": "952-206-7731",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6800 France Ave S",
            "address_2": "#147",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554352031",
            "country_code": "US",
            "telephone_number": "952-929-1981",
            "fax_number": "952-929-1846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIDER",
        "first_name": "ROBERT",
        "middle_name": "BRADY",
        "name_prefix": "Mr.",
        "credential": "MS/CCC-SP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "5042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA CHOICE",
            "identifier": "46000002",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA CHOICE",
            "identifier": "64601000",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "334245000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHOICE PLUS/PATIENT CHOIC",
            "identifier": "134612",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "05995GR",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany S Goodman, CMT
• Walter Richard Grabner, DDS
• Kevin William Gracie, CST/CFA
• Sarah Granger, LICSW
• Nathaniel James Gray
• Brian Joseph Grosam, PHD, TCMD, LAC
• Charlotte Louise Groves, LMFT
• Joan Gudorf, LICSW
• Donna Guillory, PHARMD
• Jeffrey Thomas Gullickson, DC

• Speech-Language Pathologist in Hopkins, MN
• Providers in Hopkins, 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 Aug 19, 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.