Individual provider Active NPI

Lauren Alexis Martinez, SLPA

  • Speech-Language Pathologist
  • Phoenix, AZ
National Provider Identifier
1609429877
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLPA11878 Issued in AZ
Practice address
21630 N 19TH Ave Ste B3
Phoenix, AZ 85027-2717
Phone
(602) 726-2300
NPI assigned
Jul 17, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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 SLPA11878 AZ Primary

Addresses

Primary practice location

21630 N 19TH Ave Ste B3
Phoenix, AZ 85027-2717

Mailing address

6234 W Behrend Dr Apt 1136
Glendale, AZ 85308-6910
Phone (915) 346-3451

Other identifiers 1

IdentifierTypeStateIssuer
32686MedicaidAZ

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
SLPA11878AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Theraplay4Kidz, LLC Speech-Language Pathologist CurrentSince Oct 14, 2019 Accepting new patients

Locations

21630 N 19th Ave
Ste B3
Phoenix, AZ 85027
Phone (480) 235-7588

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": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1609429877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6234 W BEHREND DR APT 1136",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086910",
            "telephone_number": "915-346-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21630 N 19TH AVE STE B3",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850272717",
            "telephone_number": "602-726-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "LAUREN",
        "middle_name": "ALEXIS",
        "credential": "SLPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLPA11878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32686",
            "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 Jul 17, 2019; 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.