Active NPI
Tayler Shea Thompson, MS, CCC-SLP
- Speech-Language Pathologist
- Irvine, CA
National Provider Identifier
1144623703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP27226
- Practice address
- 17461 Derian Ave Ste 114
Irvine, CA 92614-5820 - Phone
- (949) 788-9236
- NPI assigned
- Sep 26, 2014
- Last updated
- Jun 27, 2019
- 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 | SP27226 | CA | Primary |
Addresses
Primary practice location
17461 Derian Ave Ste 114
Irvine, CA 92614-5820
Mailing address
17461 Derian Ave Ste 114
Irvine, CA 92614-5820
Phone (949) 788-9236
Other practice location 1
1120 Via Callejon Ste B
San Clemente, CA 92673-6264
Phone (949) 498-5100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SP27226 | Other | CA | SPEECH-LANGUAGE PATHOLOGY |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP27226 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Icec | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561593600000",
"number": "1144623703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17461 DERIAN AVE STE 114",
"city": "IRVINE",
"state": "CA",
"postal_code": "926145820",
"telephone_number": "949-788-9236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17461 DERIAN AVE STE 114",
"city": "IRVINE",
"state": "CA",
"postal_code": "926145820",
"telephone_number": "949-788-9236"
}
],
"practiceLocations": [
{
"address_1": "1120 Via Callejon Ste B",
"address_purpose": "LOCATION",
"city": "San Clemente",
"state": "CA",
"postal_code": "926736264",
"country_code": "US",
"telephone_number": "949-498-5100",
"fax_number": "949-366-5665",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THOMPSON",
"first_name": "TAYLER",
"middle_name": "SHEA",
"credential": "MS, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-26",
"last_updated": "2019-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "SP27226",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPEECH-LANGUAGE PATHOLOGY",
"identifier": "SP27226",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.