Active NPI
Gregory Charles Zoller
- Speech-Language Pathologist
- Minneapolis, MN
National Provider Identifier
1932892072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP.16002
- Practice address
- 1 Veterans Dr
Minneapolis, MN 55417-2309 - Phone
- (612) 725-2000
- NPI assigned
- Jun 2, 2023
- Sex
- Male
- 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 | SP.16002 | OH | Primary |
Addresses
Primary practice location
1 Veterans Dr
Minneapolis, MN 55417-2309
Mailing address
4555 Minnehaha Ave Unit 208
Minneapolis, MN 55406-3998
Phone (513) 600-9345
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
| License | State | Type | Specialty |
|---|---|---|---|
| SP.16002 | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724284800000",
"number": "1932892072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4555 MINNEHAHA AVE UNIT 208",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554063998",
"telephone_number": "513-600-9345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 VETERANS DR",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554172309",
"telephone_number": "612-725-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZOLLER",
"first_name": "GREGORY",
"middle_name": "CHARLES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-02",
"last_updated": "2024-08-22",
"certification_date": "2024-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "SP.16002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.