Active NPI
Patricia Jo Cowperthwaite
- Speech-Language Pathologist
- Clermont, FL
National Provider Identifier
1255474656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4349
- Practice address
- 10604 Cedar Forest Cir
Clermont, FL 34711-6151 - Phone
- (623) 340-1500
- NPI assigned
- Feb 15, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 4349 | AZ | Primary |
Addresses
Primary practice location
10604 Cedar Forest Cir
Clermont, FL 34711-6151
Mailing address
4870 N Litchfield Rd
Ste 101
Litchfield Park, AZ 85340-5041
Phone (623) 935-6040
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4349 | AZ | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Theracare PLLC | Speech-Language Pathologist | Current | Accepting new patients |
Locations
2830 E Brown Rd
Ste 1
Mesa, AZ 85213
Phone (480) 830-1188
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": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580774400000",
"number": "1255474656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4870 N LITCHFIELD RD",
"address_2": "STE 101",
"city": "LITCHFIELD PARK",
"state": "AZ",
"postal_code": "853405041",
"telephone_number": "623-935-6040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10604 CEDAR FOREST CIR",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347116151",
"telephone_number": "623-340-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COWPERTHWAITE",
"first_name": "PATRICIA",
"middle_name": "JO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-15",
"last_updated": "2020-02-04",
"certification_date": "2020-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "4349",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clermont, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.