Individual provider Active NPI

Moni A Orsillo, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Colorado Springs, CO
National Provider Identifier
1528120755
Registry record updated Nov 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
12074445 Issued in CO
Practice address
125 N Parkside Dr Ste 204
Colorado Springs, CO 80909-6097
Phone
(719) 650-9947
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2009

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 12074445 CO Primary

Addresses

Primary practice location

125 N Parkside Dr Ste 204
Colorado Springs, CO 80909-6097

Mailing address

2147 Denton GRV Apt 202
Colorado Springs, CO 80919-5109
Phone (719) 650-9947

Other identifiers 1

IdentifierTypeStateIssuer
62922572MedicaidCO

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

LicenseStateTypeSpecialty
12074445COMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259452800000",
    "number": "1528120755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2147 DENTON GRV APT 202",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809195109",
            "telephone_number": "719-650-9947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N PARKSIDE DR STE 204",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809096097",
            "telephone_number": "719-650-9947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORSILLO",
        "first_name": "MONI",
        "middle_name": "A",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2009-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "12074445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "62922572",
            "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 Nov 29, 2009; 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.