Individual provider Active NPI

Adrianna Ackerman Avery, CCC-SLP

  • Speech-Language Pathologist
  • Castle Rock, CO
National Provider Identifier
1326350109
Registry record updated Aug 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
12130383 Issued in CO
Practice address
1450 Black Pine CT
Castle Rock, CO 80104-7610
Phone
(970) 590-9241
NPI assigned
Jul 8, 2010
Last updated
Aug 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 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 Pathologist 235Z00000X 191025 CO
Speech-Language Pathologist 235Z00000X 12130383 CO Primary

Addresses

Primary practice location

1450 Black Pine CT
Castle Rock, CO 80104-7610

Mailing address

1450 Black Pine CT
Castle Rock, CO 80104-7610
Phone (970) 590-9241

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

LicenseStateTypeSpecialty
12130383COMDSpeech-Language Pathologist
191025COMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bridges Pediatric Speech Therapy LLC CurrentSince Sep 15, 2019 Accepting new patients
Foothills Speech and Language LLC Speech-Language Pathologist PastSince Jul 2, 2009 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, 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": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565395200000",
    "number": "1326350109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 BLACK PINE CT",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801047610",
            "telephone_number": "970-590-9241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 BLACK PINE CT",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801047610",
            "telephone_number": "970-590-9241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERY",
        "first_name": "ADRIANNA",
        "middle_name": "ACKERMAN",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2019-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "191025",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "12130383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castle Rock, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.