Active NPI
Anita Barbara Ortega, MA, CCC-SLP
- Speech-Language Pathologist
- Pueblo, CO
National Provider Identifier
1700815792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 12050828
- Practice address
- 5642 Aventura Way
Pueblo, CO 81005-3362 - Phone
- (719) 369-8569
- Fax
- (719) 561-0791
- NPI assigned
- Jul 2, 2006
- 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 | 12050828 | CO | Primary |
Addresses
Primary practice location
5642 Aventura Way
Pueblo, CO 81005-3362
Mailing address
5642 Aventura Way
Pueblo, CO 81005-3362
Phone (719) 369-8569
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38820862 | Medicaid | CO |
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 |
|---|---|---|---|
| 12050828 | CO | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474588800000",
"number": "1700815792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5642 AVENTURA WAY",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810053362",
"telephone_number": "719-369-8569",
"fax_number": "719-561-0791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5642 AVENTURA WAY",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810053362",
"telephone_number": "719-369-8569",
"fax_number": "719-561-0791"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORTEGA",
"first_name": "ANITA",
"middle_name": "BARBARA",
"name_prefix": "Ms.",
"credential": "MA, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-02",
"last_updated": "2016-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CO",
"license": "12050828",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38820862",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.