Individual provider Active NPI

Carmen Marie Heitzer-Winer, CCC-SLP

  • Speech-Language Pathologist
  • Colorado Springs, CO
National Provider Identifier
1154579407
Registry record updated Aug 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 6678 Issued in FL
Practice address
3090 N Academy Blvd
Colorado Springs, CO 80917-5310
Phone
(719) 574-8300
Fax
(719) 574-9547
NPI assigned
Aug 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2008

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 SA 6678 FL Primary

Addresses

Primary practice location

3090 N Academy Blvd
Colorado Springs, CO 80917-5310

Mailing address

5248 Prairie Grass LN
Colorado Springs, CO 80922-2221
Phone (719) 358-7975

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

State licenses

LicenseStateTypeSpecialty
SA 6678FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219881600000",
    "number": "1154579407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5248 PRAIRIE GRASS LN",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809222221",
            "telephone_number": "719-358-7975",
            "fax_number": "719-574-9547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3090 N ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175310",
            "telephone_number": "719-574-8300",
            "fax_number": "719-574-9547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEITZER-WINER",
        "first_name": "CARMEN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-28",
        "last_updated": "2008-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 6678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; 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.