Active NPI
Colin Matthew McInnis, SLPA
- Speech-Language Assistant
- Oakland, CA
National Provider Identifier
1407418189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 5577
- Practice address
- 4400 Keller Ave Ste 200
Oakland, CA 94605-4229 - Phone
- (510) 639-2929
- NPI assigned
- Jul 3, 2019
- Sex
- Male
- 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 Assistant | 2355S0801X | 5577 | CA | Primary |
Addresses
Primary practice location
4400 Keller Ave Ste 200
Oakland, CA 94605-4229
Mailing address
131 Chilpancingo Pkwy Apt 283
Pleasant Hill, CA 94523-1351
Phone (209) 479-4184
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5577 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562112000000",
"number": "1407418189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "131 CHILPANCINGO PKWY APT 283",
"city": "PLEASANT HILL",
"state": "CA",
"postal_code": "945231351",
"telephone_number": "209-479-4184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 KELLER AVE STE 200",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946054229",
"telephone_number": "510-639-2929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINNIS",
"first_name": "COLIN",
"middle_name": "MATTHEW",
"name_prefix": "Mr.",
"credential": "SLPA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-03",
"last_updated": "2019-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "CA",
"license": "5577",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.