Individual provider Active NPI

Andrea Dawn Matson, BS

  • Speech-Language Assistant
  • Phoenix, AZ
National Provider Identifier
1508170606
Registry record updated Jul 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SLPA6843 Issued in AZ
Practice address
14435 N 7TH St
Suite 300
Phoenix, AZ 85022-4371
Phone
(602) 547-6996
Fax
(602) 457-6952
NPI assigned
Jul 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SLPA6843 AZ Primary

Addresses

Primary practice location

14435 N 7TH St
Suite 300
Phoenix, AZ 85022-4371

Mailing address

3614 W Marconi Ave
Phoenix, AZ 85053-7652
Phone (602) 621-1293

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
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
SLPA6843AZMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1280448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280448000000",
    "number": "1508170606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3614 W MARCONI AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850537652",
            "telephone_number": "602-621-1293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14435 N 7TH ST",
            "address_2": "SUITE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850224371",
            "telephone_number": "602-547-6996",
            "fax_number": "602-457-6952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATSON",
        "first_name": "ANDREA",
        "middle_name": "DAWN",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-30",
        "last_updated": "2010-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "SLPA6843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.

Verify at the official NPI Registry.