Individual provider Active NPI

Rebecca Picciano, B.S., SLPA

  • Speech-Language Assistant
  • Scottsdale, AZ
National Provider Identifier
1265862296
Registry record updated Nov 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SLPA8594 Issued in AZ
Practice address
10049 E Dynamite Blvd
Ste. 110
Scottsdale, AZ 85262-3694
Phone
(480) 419-0848
Fax
(480) 538-5258
NPI assigned
Nov 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SLPA8594 AZ Primary

Addresses

Primary practice location

10049 E Dynamite Blvd
Ste. 110
Scottsdale, AZ 85262-3694

Mailing address

34130 N Barbara Dr
San Tan Valley, AZ 85142-3118
Phone (480) 980-9372

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
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
SLPA8594AZMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamite Therapy, LLC PastSince Sep 9, 2011 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1384214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384214400000",
    "number": "1265862296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34130 N BARBARA DR",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851423118",
            "telephone_number": "480-980-9372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10049 E DYNAMITE BLVD",
            "address_2": "STE. 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852623694",
            "telephone_number": "480-419-0848",
            "fax_number": "480-538-5258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICCIANO",
        "first_name": "REBECCA",
        "name_prefix": "Ms.",
        "credential": "B.S., SLPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-12",
        "last_updated": "2013-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "SLPA8594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; 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.