Angela Dawn Elliott, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

1124 Field Ave
Canon City, CO 81212-9252

Phone

(719) 276-0991

NPI assigned

May 11, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

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.

• The Speech Garden LLC

  • Hearing and Speech Clinic/Center
  • Canon City, CO
  • NPI 1881248722

  CO

  Medicare reassignment NPD Authorized official
• Flanagan Speech Services Corp

  • Hearing and Speech Clinic/Center
  • Canon City, CO
  • NPI 1356574453
  NPD (past)

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

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1003108960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 FIELD AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812129252",
            "telephone_number": "719-371-1510",
            "fax_number": "888-375-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 FIELD AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812129252",
            "telephone_number": "719-276-0991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 N Raynolds Ave",
            "address_purpose": "LOCATION",
            "city": "Canon City",
            "state": "CO",
            "postal_code": "812122740",
            "country_code": "US",
            "telephone_number": "719-276-0991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "ANGELA",
        "middle_name": "DAWN",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-11",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "67871879",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dave Earl Egerdahl, R.D.
• Elevation Counseling Services Inc.
• Elite Dental Group Canon City Inc
• Ellington Eyecare PLLC
• Steven Michael Ellington
• Erica K Elliott, LPC
• Karolyn G Ellis, PHYSICAL THERAPIST
• William Lee Elzi, MD
• Michelle Renee Emond
• Heather Engle, BA

• All providers in Canon City, CO
• Speech-Language Pathologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; 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.