NPIMap

Organization Active NPI

Sandia Speech Language Therapy LLC

  • Speech-Language Pathologist
  • Albuquerque, NM
National Provider Identifier
1063173060
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
SANDIA SPEECH LANGUAGE THERAPY LLC
Practice address
917 Tramway LN NE
Albuquerque, NM 87122-1309
Phone
(701) 202-8281
NPI assigned
Jan 3, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jenna Berg, M.S., CCC-SLPNPI 1821514530
Title
Speech Language Pathologist
Phone
(701) 202-8281

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

917 Tramway LN NE
Albuquerque, NM 87122-1309

Mailing address

PO Box 53594
Albuquerque, NM 87153-3594
Phone (701) 202-8281

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1641168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641168000000",
    "number": "1063173060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53594",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871533594",
            "telephone_number": "701-202-8281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 TRAMWAY LN NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871221309",
            "telephone_number": "701-202-8281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDIA SPEECH LANGUAGE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-03",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "JENNA",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "701-202-8281",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.