Individual provider Active NPI

Colette Suzanne Powell, M.N.S. CCC-SLP

  • Speech-Language Pathologist
  • Apache Junction, AZ
National Provider Identifier
1336369776
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP4189 Issued in AZ
Practice address
550 S Ironwood Dr
Apache Junction, AZ 85220-5002
Phone
(480) 982-1110
Fax
(480) 474-8370
NPI assigned
Apr 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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 SLP4189 AZ Primary

Addresses

Primary practice location

550 S Ironwood Dr
Apache Junction, AZ 85220-5002

Mailing address

7831 E Culver St
Mesa, AZ 85207-1205
Phone (480) 982-1110

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
SLP4189AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Essential Therapy Solutions, LLC Speech-Language Pathologist Past Accepting new patients
Superstition Mountain Elementary School Past 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": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336369776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7831 E CULVER ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852071205",
            "telephone_number": "480-982-1110",
            "fax_number": "480-474-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S IRONWOOD DR",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "852205002",
            "telephone_number": "480-982-1110",
            "fax_number": "480-474-8370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "COLETTE",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "M.N.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP4189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apache Junction, 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.