Active NPI
Sally V Matchette, SLP
- Speech-Language Pathologist
- Minneapolis, MN
National Provider Identifier
1962598946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7262
- Practice address
- 2450 Riverside Ave
Minneapolis, MN 55454-1450 - Phone
- (612) 672-6000
- NPI assigned
- Oct 5, 2006
- 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 | 7262 | MN | Primary |
Addresses
Primary practice location
2450 Riverside Ave
Minneapolis, MN 55454-1450
Mailing address
9866 Kirkwood LN N
Maple Grove, MN 55369-6602
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1350 Saint Peter St
Delano, MN 55328-2837
Phone (763) 213-3394
1861 Commerce Blvd
Mound, MN 55364-1293
Phone (952) 463-6211
827 Mayowood Rd SW
Rochester, MN 55902-2583
Phone (507) 413-7678
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7262 | MN | MD | Chiropractor |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962598946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9866 KIRKWOOD LN N",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553696602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2450 RIVERSIDE AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554541450",
"telephone_number": "612-672-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATCHETTE",
"first_name": "SALLY",
"middle_name": "V",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MN",
"license": "7262",
"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 Jul 8, 2007; 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.