Individual provider Active NPI

Cindy Ann Burk, M.S.,C.C.C.-SLP

  • Speech-Language Pathologist
  • Surprise, AZ
National Provider Identifier
1629122494
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP0118 Issued in AZ
Practice address
17999 W. Surprise Farms Loop South
Surprise, AZ 85388
Phone
(623) 876-7350
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 SLP0118 AZ Primary

Addresses

Primary practice location

17999 W. Surprise Farms Loop South
Surprise, AZ 85388

Mailing address

12414 W Coronet Dr
Sun City West, AZ 85375-5122
Phone (623) 877-1513

Other identifiers 1

IdentifierTypeStateIssuer
54278OtherAZAHCCS ID NUMBER

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 Science

State licenses

LicenseStateTypeSpecialty
SLP0118AZMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629122494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12414 W CORONET DR",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755122",
            "telephone_number": "623-877-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17999 W. SURPRISE FARMS LOOP SOUTH",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "85388",
            "telephone_number": "623-876-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURK",
        "first_name": "CINDY",
        "middle_name": "ANN",
        "credential": "M.S.,C.C.C.-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP0118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCS ID NUMBER",
            "identifier": "54278",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, 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.

Verify at the official NPI Registry.