Emilie Bonkrud

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

License

SLPA12174 Issued in AZ

Practice address

3941 E Baseline Rd Ste 101
Gilbert, AZ 85234-2750

Phone

(480) 787-5446

NPI assigned

Mar 20, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1584662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1669008793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 E 3RD ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852038113",
            "telephone_number": "480-332-6690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3941 E BASELINE RD STE 101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342750",
            "telephone_number": "480-787-5446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9150 W Indian School Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850372385",
            "country_code": "US",
            "telephone_number": "480-787-5387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONKRUD",
        "first_name": "EMILIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-20",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "SLPA12174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Assistant in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Speech-Language Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.