Individual provider Active NPI

Kristyn Carlson

  • Speech-Language Pathologist
  • Fountain Hills, AZ
National Provider Identifier
1154839090
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
17100 E Shea Blvd Ste 600
Fountain Hills, AZ 85268-6663
Phone
(480) 837-4565
NPI assigned
Jan 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SLPA10140 AZ
Speech-Language Pathologist 235Z00000X AZ Primary

Addresses

Primary practice location

17100 E Shea Blvd Ste 600
Fountain Hills, AZ 85268-6663

Mailing address

17100 E Shea Blvd Ste 600
Fountain Hills, AZ 85268-6663

Other practice location 1

2150 S Country Club Dr
Mesa, AZ 85210-6809
Phone (480) 398-4280

Other practice location 2

10631 S 51st St Ste 8
Phoenix, AZ 85044-5225
Phone (480) 398-4280

Other practice location 3

3011 S Lindsay Rd Ste 103
Gilbert, AZ 85295-4333
Phone (480) 398-4280

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
SLPA10140AZMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cholla Medical Group, Inc PastSince Dec 15, 2006 Accepting new patients
Piller Child Development LLC Speech-Language Pathologist PastSince Nov 1, 2017 Accepting new patients

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": "1515715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1154839090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17100 E SHEA BLVD STE 600",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852686663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 E SHEA BLVD STE 600",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852686663",
            "telephone_number": "480-837-4565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2150 S Country Club Dr",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852106809",
            "country_code": "US",
            "telephone_number": "480-398-4280",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10631 S 51st St Ste 8",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850445225",
            "country_code": "US",
            "telephone_number": "480-398-4280",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3011 S Lindsay Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852954333",
            "country_code": "US",
            "telephone_number": "480-398-4280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "KRISTYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-12",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "SLPA10140",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Hills, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; 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.