Individual provider Active NPI

Erika Kessenich, SPT

  • Speech-Language Pathologist
  • Flagstaff, AZ
National Provider Identifier
1427146448
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP4135 Issued in AZ
Practice address
125 E Elm Ave
Ste 103
Flagstaff, AZ 86001-3258
Phone
(928) 779-1679
Fax
(928) 779-2822
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

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 SLP4135 AZ Primary

Addresses

Primary practice location

125 E Elm Ave
Ste 103
Flagstaff, AZ 86001-3258

Mailing address

125 E Elm Ave
Ste 103
Flagstaff, AZ 86001-3258
Phone (928) 779-1679

Other identifiers 1

IdentifierTypeStateIssuer
802852OtherAZAHCCCS NUMBER

Other names 1

  • Erika Palm Former name

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
SLP4135AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Northland-Rural Therapy Associates, LLC Speech-Language Pathologist PastSince Jan 1, 2013 Accepting new patients

Organizations & group practices 1

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427146448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E ELM AVE",
            "address_2": "STE 103",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013258",
            "telephone_number": "928-779-1679",
            "fax_number": "928-779-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E ELM AVE",
            "address_2": "STE 103",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013258",
            "telephone_number": "928-779-1679",
            "fax_number": "928-779-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESSENICH",
        "first_name": "ERIKA",
        "credential": "SPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP4135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS NUMBER",
            "identifier": "802852",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIKA",
            "last_name": "PALM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Flagstaff, 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.