Active NPI
Deanna Jones, M.S., CCC-SLP
- Speech-Language Pathologist
- Albuquerque, NM
National Provider Identifier
1104911148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1896
- Practice address
- 4808 San Timoteo Ave NW
Albuquerque, NM 87114-3833 - Phone
- (505) 328-0443
- Fax
- (505) 898-7378
- NPI assigned
- Oct 4, 2006
- 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 | 1896 | NM | Primary |
Addresses
Primary practice location
4808 San Timoteo Ave NW
Albuquerque, NM 87114-3833
Mailing address
4808 San Timoteo Ave NW
Albuquerque, NM 87114-3833
Phone (505) 328-0443
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| QMYPR0072409 | Other | NM | MOLINA HEALTH CARE |
| 67308066 | Medicaid | NM | |
| 10026765 | Other | NM | LOVELACE HEALTH PLAN |
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1896 | NM | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433376000000",
"number": "1104911148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4808 SAN TIMOTEO AVE NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871143833",
"telephone_number": "505-328-0443",
"fax_number": "505-898-7378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4808 SAN TIMOTEO AVE NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871143833",
"telephone_number": "505-328-0443",
"fax_number": "505-898-7378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "DEANNA",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2015-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NM",
"license": "1896",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOLINA HEALTH CARE",
"identifier": "QMYPR0072409",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "67308066",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LOVELACE HEALTH PLAN",
"identifier": "10026765",
"state": "NM"
}
],
"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 Jun 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.