Individual provider Active NPI

Summer Stout-Bloyer

  • Speech-Language Assistant
  • Phoenix, AZ
National Provider Identifier
1740610534
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SLPA8608 Issued in AZ
Practice address
20402 N 15TH Ave
Phoenix, AZ 85027-3636
Phone
(623) 445-4952
Fax
(623) 445-5083
NPI assigned
Nov 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SLPA8608 AZ Primary

Addresses

Primary practice location

20402 N 15TH Ave
Phoenix, AZ 85027-3636

Mailing address

20402 N 15TH Ave
Phoenix, AZ 85027-3636
Phone (623) 445-4952

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200813003429 AZ Practitioner - Qualified Speech Language Pathologist 2365868841 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SLPA8608AZMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Theracare PLLC Speech-Language Pathologist CurrentSince May 5, 2020 Accepting new patients
Heartland Therapy, Inc. CurrentSince May 5, 2020 Accepting new patients

Locations

2830 E Brown Rd
Ste 1
Mesa, AZ 85213
Phone (480) 830-1188

530 E McDowell Rd
Ste 107475
Phoenix, AZ 85004

Organizations & group practices 2

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": "1384473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384473600000",
    "number": "1740610534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20402 N 15TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850273636",
            "telephone_number": "623-445-4952",
            "fax_number": "623-445-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20402 N 15TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850273636",
            "telephone_number": "623-445-4952",
            "fax_number": "623-445-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT-BLOYER",
        "first_name": "SUMMER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-15",
        "last_updated": "2013-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "SLPA8608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; 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.