Active NPI
Lindsay Ketels, M.A. CCC-SLP
- Speech-Language Pathologist
- Coralville, IA
National Provider Identifier
1962814277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 073963
- Practice address
- 2350 Oakdale Blvd
Coralville, IA 52241-9702 - Phone
- (319) 351-5437
- Fax
- (319) 351-5432
- NPI assigned
- May 21, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | IA | ||
| Speech-Language Pathologist | 235Z00000X | 073963 | IA | Primary |
Addresses
Primary practice location
2350 Oakdale Blvd
Coralville, IA 52241-9702
Mailing address
2350 Oakdale Blvd
Coralville, IA 52241-9702
Phone (319) 351-5437
Other names 1
- Lindsay Borgwardt
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 073963 | IA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childserve Therapy, Inc. | Speech-Language Pathologist | Past | Accepting new patients |
| The Childserve Clinic Inc | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622073600000",
"number": "1962814277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2350 OAKDALE BLVD",
"city": "CORALVILLE",
"state": "IA",
"postal_code": "522419702",
"telephone_number": "319-351-5437",
"fax_number": "319-351-5432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2350 OAKDALE BLVD",
"city": "CORALVILLE",
"state": "IA",
"postal_code": "522419702",
"telephone_number": "319-351-5437",
"fax_number": "319-351-5432"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KETELS",
"first_name": "LINDSAY",
"name_prefix": "Mrs.",
"credential": "M.A. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-21",
"last_updated": "2021-05-27",
"certification_date": "2021-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IA",
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IA",
"license": "073963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LINDSAY",
"last_name": "BORGWARDT",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Coralville, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.