Individual provider Active NPI

Lynn U. Hedrick, MA,CCC,SLP,CDRS

  • Contractor
  • Phoenix, AZ
National Provider Identifier
1184914434
Registry record updated May 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
1145 Issued in AZ
Practice address
4120 N 20TH St
Ste. G
Phoenix, AZ 85016-6022
Phone
(602) 881-9500
Fax
(602) 957-2943
NPI assigned
Apr 7, 2011
Last updated
May 2, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 1145 AZ Primary
Speech-Language Pathologist 235Z00000X SLP5795 AZ

Addresses

Primary practice location

4120 N 20TH St
Ste. G
Phoenix, AZ 85016-6022

Mailing address

4120 N 20TH St
Ste. G
Phoenix, AZ 85016-6022
Phone (602) 881-9500

Other identifiers 2

IdentifierTypeStateIssuer
SLP5795OtherAZAZ DEPT OF HEALTH SERVICES
01113520OtherMDAMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1145AZMDPhysical Therapist
SLP5795AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Drivable Solutions, Inc. 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304294400000",
    "number": "1184914434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 N 20TH ST",
            "address_2": "STE. G",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850166022",
            "telephone_number": "602-881-9500",
            "fax_number": "602-957-2943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 N 20TH ST",
            "address_2": "STE. G",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850166022",
            "telephone_number": "602-881-9500",
            "fax_number": "602-957-2943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDRICK",
        "first_name": "LYNN",
        "middle_name": "U.",
        "name_prefix": "Ms.",
        "credential": "MA,CCC,SLP,CDRS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-07",
        "last_updated": "2011-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "AZ",
            "license": "1145",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP5795",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ DEPT OF HEALTH SERVICES",
            "identifier": "SLP5795",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION",
            "identifier": "01113520",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; 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.