Active NPI
Tilly Rose Cornblatt
- Speech-Language Pathologist
- Denver, CO
National Provider Identifier
1033945340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 0006071
- Practice address
- 695 S Colorado Blvd Ste 20
Denver, CO 80246-8010 - Phone
- (303) 360-0727
- NPI assigned
- Sep 12, 2024
- Sex
- Female
- 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 | 0006071 | CO | Primary |
Addresses
Primary practice location
695 S Colorado Blvd Ste 20
Denver, CO 80246-8010
Mailing address
695 S Colorado Blvd Ste 20
Denver, CO 80246-8010
Phone (303) 360-0727
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0006071 | CO | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spark Health at Home LLC | Speech-Language Pathologist | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/21392/brand/1/csg/1/fhir/r4
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": "1726099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726099200000",
"number": "1033945340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "695 S COLORADO BLVD STE 20",
"city": "DENVER",
"state": "CO",
"postal_code": "802468010",
"telephone_number": "303-360-0727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "695 S COLORADO BLVD STE 20",
"city": "DENVER",
"state": "CO",
"postal_code": "802468010",
"telephone_number": "303-360-0727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORNBLATT",
"first_name": "TILLY",
"middle_name": "ROSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-12",
"last_updated": "2024-09-12",
"certification_date": "2024-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CO",
"license": "0006071",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.