Individual provider Active NPI

Erin Diane Sargent, M.S.

  • Speech-Language Pathologist
  • Avondale, AZ
National Provider Identifier
1114111010
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
TSLP5628 Issued in AZ
Practice address
12409 W Indian School Rd
Ste C-306
Avondale, AZ 85392-9502
Phone
(315) 935-6040
NPI assigned
Sep 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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 TSLP5628 AZ Primary

Addresses

Primary practice location

12409 W Indian School Rd
Ste C-306
Avondale, AZ 85392-9502

Mailing address

1930 E Southern Ave
Tempe, AZ 85282-7518
Phone (480) 456-0719

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201118002975 AZ Practitioner - Qualified Speech Language Pathologist 4486065661 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
TSLP5628AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Solace Pediatric Healthcare Therapy Services Az, Inc. Speech-Language Pathologist CurrentSince Aug 18, 2020 Accepting new patients
Pioneer Pet, LLC PastSince Nov 22, 2020 Accepting new patients

Locations

60 E Rio Salado Pkwy
Ste 900
Tempe, AZ 85281
Phone (480) 456-0719

1930 E Southern Ave
Tempe, AZ 85282
Phone (480) 456-0719

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": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1114111010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 E SOUTHERN AVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827518",
            "telephone_number": "480-456-0719",
            "fax_number": "480-456-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12409 W INDIAN SCHOOL RD",
            "address_2": "STE C-306",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853929502",
            "telephone_number": "315-935-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARGENT",
        "first_name": "ERIN",
        "middle_name": "DIANE",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "TSLP5628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.