Individual provider Active NPI

Kristan Elizabeth Culbertson, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Flagstaff, AZ
National Provider Identifier
1285794172
Registry record updated Jan 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP1488 Issued in AZ
Practice address
1881 W Shellie Dr
Flagstaff, AZ 86001-2508
Phone
(928) 550-0056
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP1488 AZ Primary

Addresses

Primary practice location

1881 W Shellie Dr
Flagstaff, AZ 86001-2508

Mailing address

1881 W Shellie Dr
Flagstaff, AZ 86001-2508
Phone (928) 550-0056

Other identifiers 2

IdentifierTypeStateIssuer
SLP1488OtherAZDEPT. HEALTH SERVICES LIC
594748OtherAZACCHS

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
Master of Science

State licenses

LicenseStateTypeSpecialty
SLP1488AZMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230854400000",
    "number": "1285794172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 W SHELLIE DR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860012508",
            "telephone_number": "928-550-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 W SHELLIE DR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860012508",
            "telephone_number": "928-550-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULBERTSON",
        "first_name": "KRISTAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2009-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP1488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. HEALTH SERVICES LIC",
            "identifier": "SLP1488",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACCHS",
            "identifier": "594748",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2009; 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.