Individual provider Active NPI

John Kyle Meades, CCC-SLP

  • Speech-Language Pathologist
  • Tucson, AZ
National Provider Identifier
1679748396
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP5096 Issued in AZ
Practice address
821 E 47TH St
Tucson, AZ 85713-5009
Phone
(520) 232-2021
Fax
(520) 232-2553
NPI assigned
Apr 23, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP5096 AZ Primary
Speech-Language Pathologist 235Z00000X 0596 AZ

Addresses

Primary practice location

821 E 47TH St
Tucson, AZ 85713-5009

Mailing address

1830 E Broadway Blvd
Suite 124-143
Tucson, AZ 85719-5966
Phone (520) 232-2021

Other practice location 1

5700 E Pima St Ste G
Tucson, AZ 85712-5638
Phone (520) 232-2021

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0596AZMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1679748396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 E BROADWAY BLVD",
            "address_2": "SUITE 124-143",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857195966",
            "telephone_number": "520-232-2021",
            "fax_number": "520-232-2553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 E 47TH ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857135009",
            "telephone_number": "520-232-2021",
            "fax_number": "520-232-2553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5700 E Pima St Ste G",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857125638",
            "country_code": "US",
            "telephone_number": "520-232-2021",
            "fax_number": "520-232-2553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEADES",
        "first_name": "JOHN",
        "middle_name": "KYLE",
        "name_prefix": "Mr.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-23",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP5096",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "0596",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.