Individual provider Active NPI

Stephanie Stipanovich, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Glendale, AZ
National Provider Identifier
1679038970
Registry record updated Apr 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP11615 Issued in AZ
Practice address
4046 W Irma LN
Glendale, AZ 85308-4784
Phone
(563) 564-7689
NPI assigned
Jan 31, 2019
Last updated
Apr 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2023

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 SLP11615 AZ Primary

Addresses

Primary practice location

4046 W Irma LN
Glendale, AZ 85308-4784

Mailing address

4046 W Irma LN
Glendale, AZ 85308-4784
Phone (563) 564-7689

Other practice location 1

7120 E Sahuaro Dr
Scottsdale, AZ 85254-5238
Phone (563) 564-7689

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201110002707 AZ Practitioner - Qualified Speech Language Pathologist 0446660013 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SLP11615AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tauke Speech Therapy LLC Speech-Language Pathologist CurrentSince Apr 16, 2023 Accepting new patients
Theraplay4Kidz, LLC Speech-Language Pathologist CurrentSince Sep 2, 2020 Accepting new patients
Achievement Therapy Services CurrentSince Sep 2, 2020 Accepting new patients

Locations

21045 N 9th Pl
Ste 204
Phoenix, AZ 85024
Phone (480) 548-2601

530 E McDowell Rd
Ste 107495
Phoenix, AZ 85004

7120 E Sahuaro Dr
Scottsdale, AZ 85254
Phone (480) 488-3946

9525 E Doubletree Ranch Rd
Ste 101
Scottsdale, AZ 85258
Phone (480) 488-3946

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1679038970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4046 W IRMA LN",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853084784",
            "telephone_number": "563-564-7689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4046 W IRMA LN",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853084784",
            "telephone_number": "563-564-7689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7120 E Sahuaro Dr",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852545238",
            "country_code": "US",
            "telephone_number": "563-564-7689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STIPANOVICH",
        "first_name": "STEPHANIE",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-31",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP11615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.