Active NPI
Elisa Soto
- Speech-Language Pathologist
- Flagstaff, AZ
National Provider Identifier
1043585508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- TSLP7671
- Practice address
- 1805 W Heavenly CT
Flagstaff, AZ 86001-2836 - Phone
- (928) 226-1563
- NPI assigned
- Mar 16, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | TSLP7671 | AZ | Primary |
Addresses
Primary practice location
1805 W Heavenly CT
Flagstaff, AZ 86001-2836
Mailing address
5740 N Via Umbrosa
Tucson, AZ 85750-1382
Phone (520) 591-5171
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 |
|---|---|---|---|
| TSLP7671 | AZ | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dynamic Interventions of Arizona, LLC | Speech-Language Pathologist | Past | Accepting new patients |
| Dynamic Interventions of Arizona, LLC | Past | Accepting new patients |
Organizations & group practices 2
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
- Golden Valley, AZ
- NPI 1316191471
-
- Speech-Language Assistant
- Flagstaff, AZ
- NPI 1578003943
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331856000000",
"number": "1043585508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5740 N VIA UMBROSA",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857501382",
"telephone_number": "520-591-5171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1805 W HEAVENLY CT",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860012836",
"telephone_number": "928-226-1563"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOTO",
"first_name": "ELISA",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-03-16",
"last_updated": "2012-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "TSLP7671",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Flagstaff, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.