Active NPI
Kristen O'Connor, MS CCC-SLP
- Speech-Language Pathologist
- Mesa, AZ
National Provider Identifier
1326488081
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP8907
- Practice address
- 1400 S Dobson Rd
Mesa, AZ 85202-4707 - Phone
- (480) 412-7694
- NPI assigned
- Jun 26, 2013
- 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 | SLP8907 | AZ | Primary |
Addresses
Primary practice location
1400 S Dobson Rd
Mesa, AZ 85202-4707
Mailing address
1400 S Dobson Rd
Mesa, AZ 85202-4707
Phone (480) 412-7694
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SLP8907 | Medicaid | AZ |
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
| License | State | Type | Specialty |
|---|---|---|---|
| SLP8907 | AZ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553817600000",
"number": "1326488081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 S DOBSON RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852024707",
"telephone_number": "480-412-7694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 S DOBSON RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852024707",
"telephone_number": "480-412-7694"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'CONNOR",
"first_name": "KRISTEN",
"credential": "MS CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-26",
"last_updated": "2019-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "SLP8907",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SLP8907",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.