Active NPI
Elizabeth Anne Develder
- Speech-Language Pathologist
- Vermillion, SD
National Provider Identifier
1992924898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 414 E Clark St
217 Noteboom Hall
Vermillion, SD 57069-2307 - Phone
- (605) 677-6204
- NPI assigned
- Apr 25, 2007
- 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 | 070-SLP | SD | |
| Speech-Language Pathologist | 235Z00000X | Primary |
Addresses
Primary practice location
414 E Clark St
217 Noteboom Hall
Vermillion, SD 57069-2307
Mailing address
414 E Clark St
Vermillion, SD 57069-2307
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070-SLP | SD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548028800000",
"number": "1992924898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "414 E CLARK ST",
"city": "VERMILLION",
"state": "SD",
"postal_code": "570692307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "414 E CLARK ST",
"address_2": "217 NOTEBOOM HALL",
"city": "VERMILLION",
"state": "SD",
"postal_code": "570692307",
"telephone_number": "605-677-6204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVELDER",
"first_name": "ELIZABETH",
"middle_name": "ANNE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-25",
"last_updated": "2019-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "SD",
"license": "070-SLP",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vermillion, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.