NPIMap

Organization Active NPI

Champion Speech & Language Therapy LLC

  • Speech-Language Pathologist
  • Sierra Vista, AZ
National Provider Identifier
1215420757
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP9336 Issued in AZ
Legal business name
CHAMPION SPEECH & LANGUAGE THERAPY LLC
Practice address
200 E Wilcox Dr
Sierra Vista, AZ 85635-2526
Phone
(520) 458-1551
Fax
(520) 458-1896
NPI assigned
Jun 9, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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

Authorized official

Name
Mary Furry
Title
Business Manager
Phone
(520) 458-1551

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SLP9336 AZ Primary

Addresses

Primary practice location

200 E Wilcox Dr
Sierra Vista, AZ 85635-2526

Mailing address

200 E Wilcox Dr
Sierra Vista, AZ 85635-2526
Phone (520) 458-1551

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1528502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625184000000",
    "number": "1215420757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E WILCOX DR",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352526",
            "telephone_number": "520-458-1551",
            "fax_number": "520-458-1896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E WILCOX DR",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352526",
            "telephone_number": "520-458-1551",
            "fax_number": "520-458-1896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPION SPEECH & LANGUAGE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-09",
        "last_updated": "2021-07-02",
        "certification_date": "2021-06-12",
        "status": "A",
        "authorized_official_last_name": "FURRY",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "520-458-1551"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP9336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; 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.