Individual provider Active NPI

Dawn R Hart, MS. CCC-SLP

  • Speech-Language Pathologist
  • Corrales, NM
National Provider Identifier
1023157997
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2155A Issued in NM
Practice address
106 Targhetta Rd
Corrales, NM 87048-6937
Phone
(505) 450-4482
NPI assigned
Feb 6, 2007
Last updated
Nov 6, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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 2155A NM Primary

Addresses

Primary practice location

106 Targhetta Rd
Corrales, NM 87048-6937

Mailing address

106 Targhetta Rd
Corrales, NM 87048-6937
Phone (505) 450-4482

Other identifiers 1

IdentifierTypeStateIssuer
T 6448MedicaidNM

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

State licenses

LicenseStateTypeSpecialty
2155ANMMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1023157997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 TARGHETTA RD",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "870486937",
            "telephone_number": "505-450-4482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 TARGHETTA RD",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "870486937",
            "telephone_number": "505-450-4482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "DAWN",
        "middle_name": "R",
        "credential": "MS. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "2155A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T 6448",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corrales, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.