Active NPI
Tristan Neider
- Speech-Language Pathologist
- South Ogden, UT
National Provider Identifier
1306037288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 6291327-4102
- Practice address
- 5821 Willow Wood LN
South Ogden, UT 84403-5260 - Phone
- (801) 675-0164
- NPI assigned
- Aug 6, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 6291327-4102 | UT | Primary |
Addresses
Primary practice location
5821 Willow Wood LN
South Ogden, UT 84403-5260
Mailing address
5821 Willow Wood LN
South Ogden, UT 84403-5260
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6291327-4102 | UT | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186358400000",
"number": "1306037288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5821 WILLOW WOOD LN",
"city": "SOUTH OGDEN",
"state": "UT",
"postal_code": "844035260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5821 WILLOW WOOD LN",
"city": "SOUTH OGDEN",
"state": "UT",
"postal_code": "844035260",
"telephone_number": "801-675-0164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEIDER",
"first_name": "TRISTAN",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-06",
"last_updated": "2007-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "UT",
"license": "6291327-4102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.