Active NPI
Suzanne Gordon Martin, MS, CCC-SLP
- Speech-Language Pathologist
- Sandy, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 293568-4102
- Practice address
- 9720 S 1300 E Ste W130
Sandy, UT 84094-3776 - Phone
- (801) 501-2600
- NPI assigned
- Aug 7, 2018
- 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 | 293568-4102 | UT | Primary |
Addresses
Primary practice location
9720 S 1300 E Ste W130
Sandy, UT 84094-3776
Mailing address
12034 S Cortina Crest Dr
Draper, UT 84020-6106
Phone (801) 680-1561
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | smartin300553@direct.med.utah.edu | Direct | UNIVERSITY OF UTAH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 293568-4102 | UT | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients |
Locations
9660 S 1300 E
Sandy, UT 84094
Phone (801) 314-2417
1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992
1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355
Organizations & group practices 2
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.
-
dba IMED Physicians Billing
- Multi-Specialty Clinic/Center
- Murray, UT
- NPI 1629260880
-
dba Orem Community Hospital Physicians
- Multi-Specialty Clinic/Center
- Orem, UT
- NPI 1588601124
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637625600000",
"number": "1275012718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12034 S CORTINA CREST DR",
"city": "DRAPER",
"state": "UT",
"postal_code": "840206106",
"telephone_number": "801-680-1561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9720 S 1300 E STE W130",
"city": "SANDY",
"state": "UT",
"postal_code": "840943776",
"telephone_number": "801-501-2600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "SUZANNE",
"middle_name": "GORDON",
"credential": "MS, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-07",
"last_updated": "2021-11-23",
"certification_date": "2021-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "UT",
"license": "293568-4102",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "smartin300553@direct.med.utah.edu",
"affiliation": "Y",
"affiliationName": "UNIVERSITY OF UTAH",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Sandy, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; 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.