Individual provider Active NPI

Janis Rayann Dawn, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Mesa, AZ
National Provider Identifier
1679645253
Registry record updated Dec 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLPL4049 Issued in AZ
Practice address
8045 E Portobello Ave
Mesa, AZ 85212-1690
Phone
(480) 507-1404
Fax
(480) 507-1666
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2010

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 SLPL4049 AZ Primary

Addresses

Primary practice location

8045 E Portobello Ave
Mesa, AZ 85212-1690

Mailing address

8045 E Portobello Ave
Mesa, AZ 85212-1690
Phone (480) 507-1404

Other names 1

  • Mrs. Janis Rayann Nichols Former name

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 Science

State licenses

LicenseStateTypeSpecialty
SLPL4049AZMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291766400000",
    "number": "1679645253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8045 E PORTOBELLO AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852121690",
            "telephone_number": "480-507-1404",
            "fax_number": "480-507-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8045 E PORTOBELLO AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852121690",
            "telephone_number": "480-507-1404",
            "fax_number": "480-507-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWN",
        "first_name": "JANIS",
        "middle_name": "RAYANN",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2010-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLPL4049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANIS",
            "last_name": "NICHOLS",
            "middle_name": "RAYANN",
            "prefix": "MRS.",
            "credential": "M.S., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Dec 8, 2010; 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.