Active NPI
Alexis Nicole Martinez, M.A., CF-SLP
- Speech-Language Pathologist
- Mesa, AZ
National Provider Identifier
1669080594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- TSLP12408
- Practice address
- 108 W University Dr
Mesa, AZ 85201-5818 - Phone
- (480) 668-1917
- NPI assigned
- Jul 16, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | TSLP12408 | AZ | Primary |
Addresses
Primary practice location
108 W University Dr
Mesa, AZ 85201-5818
Mailing address
9408 Swan Lake Dr
Granite Bay, CA 95746-7205
Phone (916) 945-8422
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
| License | State | Type | Specialty |
|---|---|---|---|
| TSLP12408 | AZ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594857600000",
"number": "1669080594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9408 SWAN LAKE DR",
"city": "GRANITE BAY",
"state": "CA",
"postal_code": "957467205",
"telephone_number": "916-945-8422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 W UNIVERSITY DR",
"city": "MESA",
"state": "AZ",
"postal_code": "852015818",
"telephone_number": "480-668-1917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "ALEXIS",
"middle_name": "NICOLE",
"credential": "M.A., CF-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-16",
"last_updated": "2020-07-16",
"certification_date": "2020-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "TSLP12408",
"primary": true
}
],
"identifiers": [],
"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 Jul 16, 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.