Rylee Anderson
Individual provider Active NPI Speech-Language Pathologist · Mankato, MN
NPI 1972014231 · NPPES record last updated Jan 12, 2023
Key facts
- NPI
- 1972014231
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 9891 (MN)
- Practice address
- Mankato Clinic Pediatric Therapy Services
150 St. Andrews Court, Suite 310
Mankato, MN 56001 - Phone
- (507) 388-5437
- NPI assigned
- Oct 13, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191224000036 | MN | Practitioner - Qualified Speech Language Pathologist | 7012341183 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fraser | Past | Accepting new patients | |
| Fraser Child and Family Center | Past | Accepting new patients | |
| Pediatric Therapy Services Inc | Past |
Accepting new patients |
Interoperability endpoints
- ryleewagner@mklt.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 9891 | MN | Yes |
Addresses
Primary practice location
Mankato Clinic Pediatric Therapy Services
150 St. Andrews Court, Suite 310
Mankato, MN 56001
Mailing address
Mankato Clinic Pediatric Therapy Services
150 Saint Andrews Court, Suite 310
Mankato, MN 56001
Phone (507) 388-5437
Other providers in Mankato, MN
- Kurt Alan Anderson
- Makenzie Lynn Anderson
- Marlys A Anderson
- Marypat Olseth Anderson
- Patricia Ruth Anderson
- Shirley M Anderson
- Valery Joseph Andre
- Shannon Andrea
- Andrews Family Chiropractic Clinic PA
- Katlyn Marie Andrews
All providers in Mankato, MN · Speech-Language Pathologist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.