1. Home
  2. Directory
  3. Minnesota
  4. Eagan
  5. Speech Language Pathologist
  6. NPI Profile

JACLYN FRIESE-PETERSON
NPI 1790455541
Speech-Language Pathologist in Eagan, MN

Active since September 14, 2021
2795 PILOT KNOB RD STE 100, EAGAN, MN 55121(651) 994-9644 Get Directions Write a Review

NPPES record last updated: September 14, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jaclyn Friese-peterson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACLYN FRIESE-PETERSON (NPI 1790455541) is an individual speech-language pathologist provider in Eagan, Minnesota and active in the NPI registry since September 2021. She maintains a secondary practice location in Apple Valley.

NPPES Registry Identity

NPI1790455541
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameJACLYN FRIESE-PETERSON
Location Address2795 PILOT KNOB RD STE 100Eagan, MN 55121-1930
Mailing Address2795 Pilot Knob Rd Ste 100Eagan, MN 55121-1930 · (651) 994-9644
Phone(651) 994-9644
Sole ProprietorNo
Enumeration DateSeptember 14, 2021
NPPES CertifiedSeptember 14, 2021
✔ NPI 1790455541 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
2795 PILOT KNOB RD STE 100, Eagan, MN 55121
Open in Google Maps ↗

Secondary Practice Location 1

Location 114635 Pennock Ave Ste 300Apple Valley, MN 55124-6588 · Phone (651) 994-9644

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jaclyn Friese-peterson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Jaclyn Friese-peterson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Children's Therapy Center, Inc
Same address
Speech-Language Pathologist
2795 PILOT KNOB RD STE 100
Eagan, MN 55121
  • Reassigned Medicare billing, Minnesota enrollment
  • Medicare enrollment name: Childrens Therapy Center Inc
  • 38 clinicians in this Medicare group
NPI 1295809366 (651) 994-9644

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STACEY WILES OTR/L
Occupational Therapist (Pediatrics)
2795 PILOT KNOB RD STE 100
EAGAN, MN 55121
Dakota County (651) 994-9644
KELSEY FALLIGANT
Speech-Language Pathologist
2795 PILOT KNOB RD STE 100
EAGAN, MN 55121
Dakota County (651) 994-9644
SAMANTHA BECK
Speech-Language Pathologist
2795 PILOT KNOB RD STE 100
EAGAN, MN 55121
Dakota County (651) 994-9644
MANDY SANS CRAINTE OTR/L
Occupational Therapist (Pediatrics)
2795 PILOT KNOB RD STE 100
EAGAN, MN 55121
Dakota County (651) 994-9644
CAMERON ELLIS
Speech-Language Pathologist
2795 PILOT KNOB RD STE 100
EAGAN, MN 55121
Dakota County (651) 994-9644
KORIE JACKSON
Occupational Therapist
2795 PILOT KNOB RD STE 100
EAGAN, MN 55121
Dakota County (651) 994-9644
CHILDREN'S THERAPY CENTER, INC
Speech-Language Pathologist
2795 PILOT KNOB RD STE 100
EAGAN, MN 55121
Dakota County (651) 994-9644
REBECCA GRAFFDAHL
Speech-Language Pathologist
2795 PILOT KNOB RD STE 100
EAGAN, MN 55121
Dakota County (651) 994-9644

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jaclyn Friese-peterson's NPI number?

The NPI number for Jaclyn Friese-peterson is 1790455541. It was assigned to this individual provider in the NPPES registry on September 14, 2021.

Where is Jaclyn Friese-peterson located?

Jaclyn Friese-peterson practices at 2795 Pilot Knob Rd Ste 100, Eagan, MN 55121. The listed phone number is (651) 994-9644.

What is Jaclyn Friese-peterson's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Jaclyn Friese-peterson enrolled in Medicare?

Yes. Jaclyn Friese-peterson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jaclyn Friese-peterson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jaclyn Friese-peterson reassigns Medicare benefits to Children's Therapy Center, Inc (Eagan, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jaclyn Friese-peterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jaclyn Friese-peterson was last updated on September 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.