Kathleen A Carroll, MS,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP7810 Issued in AZ

Practice address

17100 E Shea Blvd Ste 600
Fountain Hills, AZ 85268

Phone

(480) 837-4565

NPI assigned

Jun 18, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Pioneer Pet, LLC

  • Diagnostic Radiology Physician
  • Tempe, AZ
  • NPI 1265401996
  NPD (past)
• Solace Pediatric Healthcare Therapy Services Az, Inc.

  • Physical Therapist
  • Tempe, AZ
  • NPI 1669533105

  Speech-Language Pathologist

  NPD (past)
• B & V Thera Pro Associates Corp

  • Clinic/Center
  • Miami, FL
  • NPI 1477635456

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1710240585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7127 W WOOD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850431590",
            "telephone_number": "352-359-2945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 E SHEA BLVD STE 600",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "85268",
            "telephone_number": "480-837-4565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3860 SW 137th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331756462",
            "country_code": "US",
            "telephone_number": "305-385-0168 x2",
            "fax_number": "305-385-0182",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1830 S Alma School Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852103088",
            "country_code": "US",
            "telephone_number": "480-902-0771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "credential": "MS,CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-18",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA14492",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "TSLP7810",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP7810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "709378",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Care Imaging and Diagnosis Limited
• Adasiah Carlson
• Kristyn Carlson
• Gino Terry Carmolli, OD
• Teresa Rae Carnell
• Loren K Carroll, PT
• Brielle Elise Casas, SLP
• Martin M Case Jr., BC-HIS ,ACA,COHC
• Emily Kate Catmull
• Cerco LLC

• Speech-Language Pathologist in Fountain Hills, AZ
• Providers in Fountain Hills, AZ by specialty
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; 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.