Active NPI
Sandra Ann Ryan, M.A., CCC-LP
- Speech-Language Pathologist
- Flagstaff, AZ
National Provider Identifier
1609072941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP1473
- Practice address
- 3150 N Winding Brook Rd
Flagstaff, AZ 86001-0972 - Phone
- (928) 774-7106
- NPI assigned
- Jun 24, 2007
- 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 | SLP1473 | AZ | Primary |
Addresses
Primary practice location
3150 N Winding Brook Rd
Flagstaff, AZ 86001-0972
Mailing address
775 N Lone Oak Way
Flagstaff, AZ 86004-5814
Phone (928) 527-9929
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)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP1473 | AZ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609072941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "775 N LONE OAK WAY",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860045814",
"telephone_number": "928-527-9929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3150 N WINDING BROOK RD",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860010972",
"telephone_number": "928-774-7106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "SANDRA",
"middle_name": "ANN",
"credential": "M.A., CCC-LP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "SLP1473",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flagstaff, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.