Individual provider Active NPI

Heidi Burnett

  • Speech-Language Pathologist
  • Colorado Springs, CO
National Provider Identifier
1376738757
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
01113646 Issued in CO
Practice address
2835 Dublin Blvd
Colorado Springs, CO 80918-1662
Phone
(719) 533-1318
Fax
(719) 533-1319
NPI assigned
Sep 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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 01113646 CO Primary

Addresses

Primary practice location

2835 Dublin Blvd
Colorado Springs, CO 80918-1662

Mailing address

2360 Montebello Square Dr
Colorado Springs, CO 80918-6977
Phone (719) 460-8386

Other identifiers 1

IdentifierTypeStateIssuer
9000176621MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090720000293 CO Practitioner - Qualified Speech Language Pathologist 0244382455 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2375 Telstar Dr
Suite 115
Colorado Springs, CO 80920-1029
Phone (719) 282-2320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01113646COMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Manual Physical Therapy, PC CurrentSince Oct 30, 2024 Accepting new patients
Synergy Manual Physical Therapy PC CurrentSince Oct 30, 2024 Accepting new patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Oct 5, 2024 Accepting new patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Oct 5, 2024 Accepting new patients
Rea Rehabilitation Services Inc Past Accepting new patients
Edge Rehabilitation & Wellness LLC Speech-Language Pathologist Past Accepting new patients

Locations

2375 Telstar Dr
Ste 115
Colorado Springs, CO 80920
Phone (719) 282-2320

600 S 21st St
Unit 130
Colorado Springs, CO 80904
Phone (719) 634-1110

12105 Ambassador Dr
Colorado Springs, CO 80921
Phone (719) 481-5161

303 N Hurstbourne Pkwy
Ste 200
Louisville, KY 40222
Phone (502) 213-7572

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1376738757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 MONTEBELLO SQUARE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809186977",
            "telephone_number": "719-460-8386",
            "fax_number": "719-522-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 DUBLIN BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809181662",
            "telephone_number": "719-533-1318",
            "fax_number": "719-533-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "HEIDI",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "01113646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000176621",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.