Individual provider Active NPI

Kimberly Kiss Marier

  • Speech-Language Pathologist
  • Maplewood, MN
National Provider Identifier
1972720902
Registry record updated May 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8098 Issued in MN
Practice address
2945 Hazelwood St Ste 100
Maplewood, MN 55109-1242
Phone
(651) 232-7800
NPI assigned
Apr 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 8098 MN Primary

Addresses

Primary practice location

2945 Hazelwood St Ste 100
Maplewood, MN 55109-1242

Mailing address

3333 University Ave SE
Minneapolis, MN 55414-3325
Phone (612) 728-5391

Other practice location 1

3333 University Ave SE
Minneapolis, MN 55414-3325
Phone (612) 728-5391

Other names 1

  • Kimberly Ann Kiss Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140213001101 MN Practitioner - Qualified Speech Language Pathologist 0244469351 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8098MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Outpatient Services, LLC Speech-Language Pathologist CurrentSince Apr 29, 2020 Accepting new patients
Therapy Associates Inc Speech-Language Pathologist CurrentSince Aug 3, 2022 Accepting new patients
Therapy Associates, Inc. Speech-Language Pathologist Past Accepting new patients
Fraser Child and Family Center PastSince Dec 11, 2020 Accepting new patients
Fraser Past Accepting new patients

Locations

13750 Crosstown Dr NW
Andover, MN 55304
Phone (763) 310-8847

904 6th Avenue Ct NE
Isanti, MN 55040
Phone (763) 444-7556

1390 University Ave W
Saint Paul, MN 55104
Phone (651) 232-4800

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

1825 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Organizations & group practices 5

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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1972720902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 UNIVERSITY AVE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143325",
            "telephone_number": "612-728-5391",
            "fax_number": "612-728-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 HAZELWOOD ST STE 100",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091242",
            "telephone_number": "651-232-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 University Ave SE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554143325",
            "country_code": "US",
            "telephone_number": "612-728-5391",
            "fax_number": "612-728-5301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARIER",
        "first_name": "KIMBERLY",
        "middle_name": "KISS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "8098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "KISS",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.