Sandra Koenig, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

24379959 Issued in CO

Practice address

San Juan Board of Cooperative Education Services (Boces
701 Camino del Rio Suite 221
Durango, CO 81301

Phone

(970) 247-3261

NPI assigned

Mar 6, 2007

Last updated

Mar 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mrs. Sandra Nettleton Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• San Juan Board of Cooperative Services

  • Local Education Agency (LEA)
  • Durango, CO
  • NPI 1851974554
  NPD (past)
• University of New Mexico

  dba UNM Cancer Research & Treatment Center

  • Clinic/Center
  • Albuquerque, NM
  • NPI 1285714766
  NPD (past)
• Unm Speech & Hearing Sciences Center

  • Community/Behavioral Health Agency
  • Albuquerque, NM
  • NPI 1013221423
  NPD (past)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1154451649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 EUBANK BLVD NE",
            "address_2": "AZTEC COMPLEX",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871121312",
            "telephone_number": "505-298-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SAN JUAN BOARD OF COOPERATIVE EDUCATION SERVICES (BOCES",
            "address_2": "701 CAMINO DEL RIO SUITE 221",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "81301",
            "telephone_number": "970-247-3261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "SANDRA",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "948",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "24379959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20789033",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "NETTLETON",
            "prefix": "MRS.",
            "credential": "CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Victoria Ruby Knauf, DPM
• Gabrielle Marie Knight
• James Knight, APN
• Christine Amanda Koch, MD
• Darci R Kochen, R.M.T.
• Kelsey Kolz, M.S., LPCC
• Jay Komarek, D.C., C.A.C.
• Kathleen Marie Korndoerfer, M.A.
• Julie Ann Kostuch, MA, LPC
• Simon Kotlyar

• Speech-Language Pathologist in Durango, CO
• Providers in Durango, CO by specialty
• Speech-Language Pathologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.