Individual provider Active NPI

Donna Lee Peterson, M.SC. SLP

  • Speech-Language Pathologist
  • Gilbert, AZ
National Provider Identifier
1053744342
Registry record updated Aug 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP8218 Issued in AZ
Practice address
3271 E Queen Creek Rd
Suite 101
Gilbert, AZ 85297-8508
Phone
(480) 621-8361
NPI assigned
Aug 9, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2013

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 SLP8218 AZ Primary

Addresses

Primary practice location

3271 E Queen Creek Rd
Suite 101
Gilbert, AZ 85297-8508

Mailing address

3466 E Longhorn Dr
Gilbert, AZ 85297-7782
Phone (480) 621-8361

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
SLP8218AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Stellar Home Health, LLC PastSince Jun 2, 2024 Accepting new patients
Desert Valley Pediatric Therapy PastSince Mar 6, 2022 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.

NPI Registry JSON

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

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376006400000",
    "number": "1053744342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3466 E LONGHORN DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852977782",
            "telephone_number": "480-621-8361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3271 E QUEEN CREEK RD",
            "address_2": "SUITE 101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852978508",
            "telephone_number": "480-621-8361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "DONNA",
        "middle_name": "LEE",
        "credential": "M.SC. SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-09",
        "last_updated": "2013-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP8218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.