Individual provider Active NPI

Kendal Lattanzi, SLP

  • Speech-Language Pathologist
  • Aurora, CO
National Provider Identifier
1760034508
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP.0004011 Issued in CO
Practice address
13123 E 16TH Ave
Aurora, CO 80045-7106
Phone
(720) 777-1234
NPI assigned
Jul 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP.0004011 CO Primary

Addresses

Primary practice location

13123 E 16TH Ave
Aurora, CO 80045-7106

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other identifiers 1

IdentifierTypeStateIssuer
0000496OtherCODEPARTMENT OF REGULATORY SERVICES

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200911001020 CO Practitioner - Qualified Speech Language Pathologist 6901224666 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SLP.0004011COMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians Incorporated CurrentSince Aug 15, 2020 Accepting new patients
University Physicians Incorporated Current Accepting new patients
University Physicians, Incorporated CurrentSince Aug 15, 2020 Accepting new patients

Locations

13123 E 16th Ave
Ste B130
Aurora, CO 80045

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

13121 E 17th Ave
Ste C234
Aurora, CO 80045
Phone (303) 724-5266

Dept 1061
Denver, CO 80256

Organizations & group practices 3

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": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1760034508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13123 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457106",
            "telephone_number": "720-777-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATTANZI",
        "first_name": "KENDAL",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "SLP.0004011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF REGULATORY SERVICES",
            "identifier": "0000496",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; 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.