Active NPI
Sean Chappell
- Speech-Language Pathologist
- Chandler, AZ
National Provider Identifier
1033303516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- TSLP5608
- Practice address
- 2040 S Alma School Rd
Suite 1 PMB 500
Chandler, AZ 85286-7075 - Phone
- (602) 323-0894
- Fax
- (602) 445-9337
- NPI assigned
- Aug 28, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | TSLP5608 | AZ | Primary |
Addresses
Primary practice location
2040 S Alma School Rd
Suite 1 PMB 500
Chandler, AZ 85286-7075
Mailing address
13385 W McDowell Rd
Goodyear, AZ 85395-2631
Phone (623) 986-5110
Other practice location 1
13385 W McDowell Rd
Goodyear, AZ 85395
Phone (623) 986-5110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150619001975 | AZ | Practitioner - Qualified Speech Language Pathologist | 1153632948 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TSLP5608 | AZ | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eleutheria, LLC | Speech-Language Pathologist | Current | Accepting new patients |
Locations
500 N Bullard Ave
Ste C27
Goodyear, AZ 85338
Phone (623) 986-5110
13385 W McDowell Rd
Goodyear, AZ 85395
Phone (623) 986-5110
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DIJFCD
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.
-
- Speech-Language Pathologist
- Goodyear, AZ
- NPI 1497027478
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607558400000",
"number": "1033303516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13385 W MCDOWELL RD",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853952631",
"telephone_number": "623-986-5110",
"fax_number": "623-207-9683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2040 S ALMA SCHOOL RD",
"address_2": "SUITE 1 PMB 500",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852867075",
"telephone_number": "602-323-0894",
"fax_number": "602-445-9337"
}
],
"practiceLocations": [
{
"address_1": "13385 W McDowell Rd",
"address_purpose": "LOCATION",
"city": "Goodyear",
"state": "AZ",
"postal_code": "85395",
"country_code": "US",
"telephone_number": "623-986-5110",
"fax_number": "623-207-9683",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHAPPELL",
"first_name": "SEAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-28",
"last_updated": "2020-12-10",
"certification_date": "2020-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "TSLP5608",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.