Individual provider Active NPI

Tina M Colbert, MA, CCC, SLP

  • Speech-Language Pathologist
  • Paradise, CA
National Provider Identifier
1336468396
Registry record updated May 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
10244 Issued in CA
Practice address
1633 Cypress Lane
Paradise, CA 95116
Phone
(971) 206-5200
Fax
(971) 206-5203
NPI assigned
May 28, 2010
Last updated
May 28, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2010

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 10244 CA Primary

Addresses

Primary practice location

1633 Cypress Lane
Paradise, CA 95116

Mailing address

4560 SE International Way
Ste 100
Milwaukie, OR 97222
Phone (971) 206-5200

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
10244CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1275004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275004800000",
    "number": "1336468396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY",
            "address_2": "STE 100",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "97222",
            "telephone_number": "971-206-5200",
            "fax_number": "971-206-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 CYPRESS LANE",
            "city": "PARADISE",
            "state": "CA",
            "postal_code": "95116",
            "telephone_number": "971-206-5200",
            "fax_number": "971-206-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBERT",
        "first_name": "TINA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MA, CCC, SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-28",
        "last_updated": "2010-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "10244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paradise, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2010; 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.