Active NPI
Christine Ann Connolly
- Speech-Language Assistant
- Phoenix, AZ
National Provider Identifier
1588912265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SLPA7974
- Practice address
- 18617 N 5TH Ave
Phoenix, AZ 85027-5675 - Phone
- (602) 703-2499
- NPI assigned
- Aug 28, 2012
- Last updated
- Aug 28, 2012
- 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 Assistant | 2355S0801X | SLPA7974 | AZ | Primary |
Addresses
Primary practice location
18617 N 5TH Ave
Phoenix, AZ 85027-5675
Mailing address
18617 N 5TH Ave
Phoenix, AZ 85027-5675
Phone (602) 703-2499
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SLPA7974 | Other | AZ | SPEECH LANGUAGE PATHOLOGY ASSISTANT LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| SLPA7974 | AZ | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346112000000",
"number": "1588912265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18617 N 5TH AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850275675",
"telephone_number": "602-703-2499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18617 N 5TH AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850275675",
"telephone_number": "602-703-2499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNOLLY",
"first_name": "CHRISTINE",
"middle_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-28",
"last_updated": "2012-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "AZ",
"license": "SLPA7974",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPEECH LANGUAGE PATHOLOGY ASSISTANT LICENSE",
"identifier": "SLPA7974",
"state": "AZ"
}
],
"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 Aug 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.