Active NPI
Kimberly Jean Van Vooren, CCC-SLP
- Speech-Language Pathologist
- Saint Cloud, MN
National Provider Identifier
1932696366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP8420
- Practice address
- 1406 6TH Ave N
Saint Cloud, MN 56303-1901 - Phone
- (320) 251-2700
- Fax
- (320) 656-7115
- NPI assigned
- Apr 20, 2018
- 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 | SLP8420 | MN | Primary |
Addresses
Primary practice location
1406 6TH Ave N
Saint Cloud, MN 56303-1901
Mailing address
1406 6TH Ave N
Saint Cloud, MN 56303-1901
Phone (320) 251-2700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP8420 | MN | MD | Speech-Language Pathologist |
| 8420 | MN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Cloud Hospital | Current | Accepting new patients | |
| St. Cloud Hospital | Current | Accepting new patients |
Locations
1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422
1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657
110 2nd St S
Ste 104
Waite Park, MN 56387
Phone (320) 259-9375
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Saint Cloud, MN
- NPI 1043269798
-
- Home Health Agency
- Waite Park, MN
- NPI 1952350605
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524182400000",
"number": "1932696366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1406 6TH AVE N",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563031901",
"telephone_number": "320-251-2700",
"fax_number": "320-656-7115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1406 6TH AVE N",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563031901",
"telephone_number": "320-251-2700",
"fax_number": "320-656-7115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN VOOREN",
"first_name": "KIMBERLY",
"middle_name": "JEAN",
"name_prefix": "Mrs.",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-20",
"last_updated": "2018-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MN",
"license": "SLP8420",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; 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.