Individual provider Active NPI

Carla Marie Zimmerman, CCC-SLP

  • Speech-Language Pathologist
  • Tempe, AZ
National Provider Identifier
1659474070
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP0024 Issued in AZ
Practice address
4700 S McClintock Dr Ste 135
Tempe, AZ 85282-7375
Phone
(602) 919-2068
Fax
(602) 224-2460
NPI assigned
Sep 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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 SLP0024 AZ Primary

Addresses

Primary practice location

4700 S McClintock Dr Ste 135
Tempe, AZ 85282-7375

Mailing address

2340 E Nora St
Mesa, AZ 85213-1572
Phone (480) 798-8556

Other identifiers 2

IdentifierTypeStateIssuer
01026746OtherASHA I.D. NUMBER
SLP0024OtherAZSTATE LICENSE

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
SLP0024AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Zimmerman Speech Therapy, Inc. Speech-Language Pathologist CurrentSince Aug 30, 2020 Accepting new patients

Locations

4700 S McClintock Dr
Ste 135
Tempe, AZ 85282
Phone (480) 719-5564

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1659474070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 E NORA ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852131572",
            "telephone_number": "480-798-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 S MCCLINTOCK DR STE 135",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827375",
            "telephone_number": "602-919-2068",
            "fax_number": "602-224-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "CARLA",
        "middle_name": "MARIE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP0024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA I.D. NUMBER",
            "identifier": "01026746",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "SLP0024",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; 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.