NPIMap

Organization Active NPI

Advanced Dysphagia Diagnostics LLC

  • Speech-Language Pathologist
  • Montrose, CO
National Provider Identifier
1366216368
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
ADVANCED DYSPHAGIA DIAGNOSTICS LLC
Practice address
104 S 1St St
Montrose, CO 81401-3635
Phone
(909) 213-5967
Fax
(509) 356-4607
NPI assigned
Nov 9, 2023
Last updated
Nov 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kimberly A SchwarzNPI 1538393756
Title
SLP / Owner
Phone
(909) 213-5967

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

104 S 1St St
Montrose, CO 81401-3635

Mailing address

2233 E Main St
Montrose, CO 81401-3831
Phone (970) 765-0831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160527000284 CO Part B Supplier - Clinic/Group Practice 4183914484 Receives reassigned benefits from 6 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Montrose, CO

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Advanced Dysphagia Diagnostics LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

611 East Star Ct
Montrose, CO 81401
Phone (970) 249-1646

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1699488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699488000000",
    "number": "1366216368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 E MAIN ST",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814013831",
            "telephone_number": "970-765-0831",
            "fax_number": "970-497-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S 1ST ST",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814013635",
            "telephone_number": "909-213-5967",
            "fax_number": "509-356-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DYSPHAGIA DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-09",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "SCHWARZ",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SLP / OWNER",
        "authorized_official_telephone_number": "909-213-5967"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.