Sondra J Bistline, M.S.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP6667 Issued in AZ

Practice address

45 North 100 East
Fredonia, AZ 86022-0843

Phone

(928) 606-3565

Fax

(928) 643-6554

NPI assigned

Oct 28, 2010

Last updated

Apr 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Speakn Up LLC

  • Speech-Language Pathologist
  • Fredonia, AZ
  • NPI 1003436700
  NPD Authorized official

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

{
    "created_epoch": "1288224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1174823843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843",
            "address_2": "45 N. 100 E.",
            "city": "FREDONIA",
            "state": "AZ",
            "postal_code": "860220843",
            "telephone_number": "928-606-3565",
            "fax_number": "928-643-6554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 NORTH 100 EAST",
            "city": "FREDONIA",
            "state": "AZ",
            "postal_code": "860220843",
            "telephone_number": "928-606-3565",
            "fax_number": "928-643-6554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISTLINE",
        "first_name": "SONDRA",
        "middle_name": "J",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-28",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "TSLP6667",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP6667",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "UT",
            "license": "8562432-4102",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cathy G. Hill, PT, LLC
• Community Bridges, Inc. (CBI - Encompass Fredonia Outpatient)
• Encompass Health Services, Inc
• Guy Ronald Finicum
• Regina Heaton Finicum

• Speech-Language Pathologist in Fredonia, AZ
• Providers in Fredonia, AZ by specialty
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.