Individual provider Active NPI

Amber Lynn Coventry, SLP

  • Speech-Language Pathologist
  • Fountain Hills, AZ
National Provider Identifier
1295208791
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
TSLP11595 Issued in AZ
Practice address
17100 E Shea Blvd Ste 600
Fountain Hills, AZ 85268-6663
Phone
(480) 837-4565
NPI assigned
Jan 7, 2019
Last updated
Jan 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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 TSLP11595 AZ Primary

Addresses

Primary practice location

17100 E Shea Blvd Ste 600
Fountain Hills, AZ 85268-6663

Mailing address

18250 N 25TH Ave Apt 1014
Phoenix, AZ 85023-1273
Phone (407) 902-5017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201008003003 AZ Practitioner - Qualified Speech Language Pathologist 0143640367 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TSLP11595AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wheels on the Bus, Inc. CurrentSince Aug 1, 2020 Accepting new patients

Locations

11811 N Tatum Blvd
Ste 3031
Phoenix, AZ 85028
Phone (480) 589-2890

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1295208791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18250 N 25TH AVE APT 1014",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850231273",
            "telephone_number": "407-902-5017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 E SHEA BLVD STE 600",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852686663",
            "telephone_number": "480-837-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVENTRY",
        "first_name": "AMBER",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-07",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "TSLP11595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Hills, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; 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.

Verify at the official NPI Registry.