NPIMap

Organization Active NPI

Sullivan Speech Language Associates

  • Speech-Language Pathologist
  • Bozeman, MT
National Provider Identifier
1265559082
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP984 Issued in MT
Legal business name
SULLIVAN SPEECH LANGUAGE ASSOCIATES
Practice address
720 Stoneridge Dr
Suite 2
Bozeman, MT 59718-7032
Phone
(406) 556-9853
NPI assigned
Mar 25, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Elizabeth M. Sullivan, M.A.CCCSLPNPI 1881743235
Title
Owner
Phone
(406) 556-9853

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP984 MT Primary

Addresses

Primary practice location

720 Stoneridge Dr
Suite 2
Bozeman, MT 59718-7032

Mailing address

129 Erik Dr
Bozeman, MT 59715-1745
Phone (406) 556-9853

Other identifiers 6

IdentifierTypeStateIssuer
662830OtherMTBCBS CHERI SORG HACKLER
0534242MedicaidMT
0532474MedicaidMT
0535347MedicaidMT
662040OtherMTBCBS NICHOLE SCALA ASSOCI
660570OtherMTBCBS ELIZABETH SULLIVAN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265559082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 ERIK DR",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597151745",
            "telephone_number": "406-556-9853",
            "fax_number": "406-586-2732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 STONERIDGE DR",
            "address_2": "SUITE 2",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597187032",
            "telephone_number": "406-556-9853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLIVAN SPEECH LANGUAGE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-556-9853",
        "authorized_official_credential": "M.A.CCCSLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MT",
            "license": "SP984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS CHERI SORG HACKLER",
            "identifier": "662830",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0534242",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0532474",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0535347",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NICHOLE SCALA ASSOCI",
            "identifier": "662040",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ELIZABETH SULLIVAN",
            "identifier": "660570",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.