Individual provider Active NPI

Lindsay Deanna Blaire, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Mesa, AZ
National Provider Identifier
1003434168
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
738 S Longmore
Mesa, AZ 85202-1908
Phone
(480) 472-4370
NPI assigned
Jul 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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 Primary

Addresses

Primary practice location

738 S Longmore
Mesa, AZ 85202-1908

Mailing address

701 W Lindner Ave
Mesa, AZ 85210-6837
Phone (480) 200-3293

Other practice location 1

651 Strander Blvd Ste 105
Tukwila, WA 98188-2914
Phone (206) 458-5360

Other practice location 2

19031 33rd Ave W Ste 101
Lynnwood, WA 98036-4731
Phone (206) 313-8840

Other practice location 3

6840 Oswego Pl NE Apt 106
Seattle, WA 98115-8430
Phone (480) 200-3293

Other practice location 4

463 S Alma School Rd
Mesa, AZ 85210-1014
Phone (480) 472-9176

Other identifiers 1

IdentifierTypeStateIssuer
111524501MedicaidWA

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)
Not enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Able Pediatric Health PastSince Aug 1, 2020 Accepting new patients

Organizations & group practices 1

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": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1003434168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W LINDNER AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106837",
            "telephone_number": "480-200-3293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "738 S LONGMORE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852021908",
            "telephone_number": "480-472-4370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "651 Strander Blvd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Tukwila",
            "state": "WA",
            "postal_code": "981882914",
            "country_code": "US",
            "telephone_number": "206-458-5360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19031 33rd Ave W Ste 101",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980364731",
            "country_code": "US",
            "telephone_number": "206-313-8840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6840 Oswego Pl NE Apt 106",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981158430",
            "country_code": "US",
            "telephone_number": "480-200-3293",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "463 S Alma School Rd",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852101014",
            "country_code": "US",
            "telephone_number": "480-472-9176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAIRE",
        "first_name": "LINDSAY",
        "middle_name": "DEANNA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "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": "111524501",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.