Individual provider Active NPI

Abbey L Fairbanks, SLP

  • Speech-Language Pathologist
  • Oro Valley, AZ
National Provider Identifier
1710001987
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP12349 Issued in AZ
Practice address
10390 N la Canada Dr Ste 110
Oro Valley, AZ 85737-7273
Phone
(520) 420-2110
Fax
(520) 420-2111
NPI assigned
Mar 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 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 146.008949 IL
Speech-Language Pathologist 235Z00000X SLP12349 AZ Primary

Addresses

Primary practice location

10390 N la Canada Dr Ste 110
Oro Valley, AZ 85737-7273

Mailing address

5301 E Grant Rd
Medical Staff
Tucson, AZ 85712-2805
Phone (520) 420-2110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221005002101 AZ Practitioner - Qualified Speech Language Pathologist 5698151264 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
146.008949ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Medical Network CurrentSince Sep 19, 2022 Accepting new patients

Locations

10390 N La Canada Dr
Ste 110
Tucson, AZ 85737
Phone (520) 420-2110

2380 N Ferguson Ave
Ste 104
Tucson, AZ 85712
Phone (520) 324-1010

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1710001987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 E GRANT RD",
            "address_2": "MEDICAL STAFF",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122805",
            "telephone_number": "520-420-2110",
            "fax_number": "520-420-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10390 N LA CANADA DR STE 110",
            "city": "ORO VALLEY",
            "state": "AZ",
            "postal_code": "857377273",
            "telephone_number": "520-420-2110",
            "fax_number": "520-420-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRBANKS",
        "first_name": "ABBEY",
        "middle_name": "L",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.008949",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP12349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oro Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.