Active NPI
Connor Donnelly, CCC-SLP
- Speech-Language Pathologist
- Centennial, CO
National Provider Identifier
1164200374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 14421164
- Practice address
- 9000 E Nichols Ave Ste 100
Centennial, CO 80112-3429 - Phone
- (720) 706-3396
- NPI assigned
- Sep 19, 2023
- Sex
- Female
- Sole proprietor
- No
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 | 14421164 | CO | Primary |
Addresses
Primary practice location
9000 E Nichols Ave Ste 100
Centennial, CO 80112-3429
Mailing address
4369 S Quebec St Apt 7201
Denver, CO 80237-2658
Phone (845) 978-1514
Other practice location 1
3401 Quebec St Ste 3500
Denver, CO 80207-2339
Phone (720) 706-3396
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
| License | State | Type | Specialty |
|---|---|---|---|
| 14421164 | CO | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Soar Health, Inc. | Speech-Language Pathologist | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695081600000",
"number": "1164200374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4369 S QUEBEC ST APT 7201",
"city": "DENVER",
"state": "CO",
"postal_code": "802372658",
"telephone_number": "845-978-1514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9000 E NICHOLS AVE STE 100",
"city": "CENTENNIAL",
"state": "CO",
"postal_code": "801123429",
"telephone_number": "720-706-3396"
}
],
"practiceLocations": [
{
"address_1": "3401 Quebec St Ste 3500",
"address_purpose": "LOCATION",
"city": "Denver",
"state": "CO",
"postal_code": "802072339",
"country_code": "US",
"telephone_number": "720-706-3396",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DONNELLY",
"first_name": "CONNOR",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-19",
"last_updated": "2023-09-19",
"certification_date": "2023-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CO",
"license": "14421164",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Centennial, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.