Individual provider Active NPI

Cynthia Eva Ruddell, MS CCC-SLP

  • Speech-Language Pathologist
  • Gilbert, AZ
National Provider Identifier
1295036077
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP7898 Issued in AZ
Practice address
2980 E Castanets CT
Gilbert, AZ 85298-8793
Phone
(480) 734-5595
NPI assigned
Nov 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SLPA6634 AZ
Speech-Language Pathologist 235Z00000X SLP7898 AZ Primary

Addresses

Primary practice location

2980 E Castanets CT
Gilbert, AZ 85298-8793

Mailing address

2980 E Castanets CT
Gilbert, AZ 85298-8793
Phone (480) 734-5595

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
SLPA6634AZMDSpeech-Language Assistant
SLP7898AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Everest Pediatric Therapy LLC Current Accepting new patients
Dynamite Therapy, LLC PastSince Sep 9, 2011 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1295036077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 E CASTANETS CT",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852988793",
            "telephone_number": "480-734-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2980 E CASTANETS CT",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852988793",
            "telephone_number": "480-734-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDDELL",
        "first_name": "CYNTHIA",
        "middle_name": "EVA",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-09",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "SLPA6634",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP7898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; 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.