Individual provider Active NPI

Heidi Connolly, M.A CCC-SLP

  • Speech-Language Pathologist
  • Austin, TX
National Provider Identifier
1619652641
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
119991 Issued in TX
Practice address
2020 S Congress Ave Apt 2122
Austin, TX 78704-5100
Phone
(737) 318-2569
NPI assigned
Jun 19, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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 119991 TX Primary

Addresses

Primary practice location

2020 S Congress Ave Apt 2122
Austin, TX 78704-5100

Mailing address

2020 S Congress Ave Apt 2122
Austin, TX 78704-5100
Phone (737) 318-2569

Other practice location 1

3809 S 2nd St Ste D200
Austin, TX 78704-7191
Phone (512) 396-0872

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
119991TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cole Consolidated Rehab LLC 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": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1619652641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 S CONGRESS AVE APT 2122",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787045100",
            "telephone_number": "737-318-2569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 S CONGRESS AVE APT 2122",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787045100",
            "telephone_number": "737-318-2569"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3809 S 2nd St Ste D200",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787047191",
            "country_code": "US",
            "telephone_number": "512-396-0872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "HEIDI",
        "credential": "M.A CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "119991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; 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.