Active NPI
Andrea Roach, M.A. CCC SLP
- Speech-Language Pathologist
- Lakewood, CO
National Provider Identifier
1477868461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA 9477
- Practice address
- 2639 S Moore Dr
Lakewood, CO 80227-6522 - Phone
- (720) 542-8021
- NPI assigned
- Aug 13, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 Pathologist | 235Z00000X | SA 9477 | FL | Primary |
Addresses
Primary practice location
2639 S Moore Dr
Lakewood, CO 80227-6522
Mailing address
2639 S Moore Drive
Lakewood, CO 80227
Phone (720) 542-8021
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA 9477 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281657600000",
"number": "1477868461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2639 S MOORE DRIVE",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "80227",
"telephone_number": "720-542-8021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2639 S MOORE DR",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "802276522",
"telephone_number": "720-542-8021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROACH",
"first_name": "ANDREA",
"credential": "M.A. CCC SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-08-13",
"last_updated": "2010-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA 9477",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.