Active NPI
Stacey R Ford, CCC-SLP
- Speech-Language Pathologist
- Mesa, AZ
National Provider Identifier
1639309164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP6245
- Practice address
- 10100 E Adobe Rd
Mesa, AZ 85207-5404 - Phone
- (480) 529-6355
- NPI assigned
- Jul 17, 2009
- Last updated
- Jun 4, 2025
- Sex
- Female
- Sole proprietor
- No
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 | SLP6245 | AZ | Primary |
Addresses
Primary practice location
10100 E Adobe Rd
Mesa, AZ 85207-5404
Mailing address
1930 E Southern Ave
Tempe, AZ 85282-7518
Phone (480) 456-0719
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 442037 | Medicaid | AZ |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pioneer Pet, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Diagnostic Radiology Physician
- Tempe, AZ
- NPI 1265401996
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748995200000",
"number": "1639309164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1930 E SOUTHERN AVE",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852827518",
"telephone_number": "480-456-0719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10100 E ADOBE RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852075404",
"telephone_number": "480-529-6355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORD",
"first_name": "STACEY",
"middle_name": "R",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-17",
"last_updated": "2025-06-04",
"certification_date": "2025-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "SLP6245",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "442037",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.