Individual provider Active NPI

Sharon Louise Crouse-Matlock

  • Speech-Language Pathologist
  • Fountain Hills, AZ
National Provider Identifier
1568871374
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
TSLP8957 Issued in AZ
Practice address
16428 E Kingstree Blvd
Fountain Hills, AZ 85268-5440
Phone
(480) 837-4565
Fax
(888) 957-8277
NPI assigned
Aug 6, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

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 TSLP8957 AZ Primary

Addresses

Primary practice location

16428 E Kingstree Blvd
Fountain Hills, AZ 85268-5440

Mailing address

1665 Cushman Dr
Sierra Vista, AZ 85635-2146
Phone (520) 495-9768

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
TSLP8957AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Student Therapies and Resource Services Speech-Language Pathologist Past 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": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407283200000",
    "number": "1568871374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 CUSHMAN DR",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352146",
            "telephone_number": "520-495-9768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16428 E KINGSTREE BLVD",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852685440",
            "telephone_number": "480-837-4565",
            "fax_number": "888-957-8277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUSE-MATLOCK",
        "first_name": "SHARON",
        "middle_name": "LOUISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-06",
        "last_updated": "2014-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "TSLP8957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Hills, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; 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.