Individual provider Active NPI

Doreen Ann Schaetz, MA,CCC-SLP

  • Speech-Language Pathologist
  • Salt Lake City, UT
National Provider Identifier
1629243274
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
293783-4102 Issued in UT
Practice address
5435 Pioneer Fork Rd
Salt Lake City, UT 84108-1675
Phone
(801) 583-6103
Fax
(801) 583-6103
NPI assigned
Apr 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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 293783-4102 UT Primary

Addresses

Primary practice location

5435 Pioneer Fork Rd
Salt Lake City, UT 84108-1675

Mailing address

5435 Pioneer Fork Rd
Salt Lake City, UT 84108-1675
Phone (801) 583-6103

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
293783-4102UTMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208995200000",
    "number": "1629243274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5435 PIONEER FORK RD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081675",
            "telephone_number": "801-583-6103",
            "fax_number": "801-583-6103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5435 PIONEER FORK RD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081675",
            "telephone_number": "801-583-6103",
            "fax_number": "801-583-6103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAETZ",
        "first_name": "DOREEN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MA,CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2008-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "UT",
            "license": "293783-4102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; 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.