Individual provider Active NPI

Annette Marie Guidry-Dunbar, MS,CCC-SLP

  • Speech-Language Pathologist
  • Prescott, AZ
National Provider Identifier
1326173170
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2141 Issued in AZ
Practice address
1722 W Pine Cone Way
Prescott, AZ 86303-7105
Phone
(928) 710-6475
NPI assigned
Feb 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2141 AZ Primary

Addresses

Primary practice location

1722 W Pine Cone Way
Prescott, AZ 86303-7105

Mailing address

1722 W Pine Cone Way
Prescott, AZ 86303-7105
Phone (928) 710-6475

Other identifiers 1

IdentifierTypeStateIssuer
748931OtherAZSTATE AHCCCS

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
2141AZMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326173170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 W PINE CONE WAY",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863037105",
            "telephone_number": "928-710-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 W PINE CONE WAY",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863037105",
            "telephone_number": "928-710-6475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIDRY-DUNBAR",
        "first_name": "ANNETTE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MS,CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "2141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE AHCCCS",
            "identifier": "748931",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.