Michele Ann Pederson, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

10197 Issued in MN

Practice address

1324 5TH North St
New Ulm, MN 56073-1514

Phone

(507) 217-5173

NPI assigned

Nov 15, 2018

Last updated

Jan 13, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1962971333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 5TH NORTH ST",
            "city": "NEW ULM",
            "state": "MN",
            "postal_code": "560731514",
            "telephone_number": "507-217-5173",
            "fax_number": "507-217-5247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 5TH NORTH ST",
            "city": "NEW ULM",
            "state": "MN",
            "postal_code": "560731514",
            "telephone_number": "507-217-5173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSON",
        "first_name": "MICHELE",
        "middle_name": "ANN",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-15",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "10197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michele.pederson@allina.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1324 5th North St",
            "city": "New Ulm",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560731514",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpederson565953@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "1324 5th North St",
            "city": "New Ulm",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560731514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lawrence V Page, DO
• Karl J Papierniak, MD
• Larry Paul Parker, D.M.D.
• John Daniel Parr, M.D.
• Sueann Paulson, RN
• Kirstin Peterson, DPT
• Stephen Theodore Petron, D.C
• Julia V Pfluger
• Amy M. Phillips, MD
• Cheryl L. Pietila, FNP-C

• Speech-Language Pathologist in New Ulm, MN
• Providers in New Ulm, 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 Jan 13, 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.