Individual provider Active NPI

Courtney Marie Dahl

  • Speech-Language Pathologist
  • Colorado Springs, CO
National Provider Identifier
1760837454
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
111603 Issued in TX
Practice address
102 S Tejon St Ste 1100
Colorado Springs, CO 80903-2253
Phone
(512) 399-0064
NPI assigned
Apr 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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 111603 TX Primary

Addresses

Primary practice location

102 S Tejon St Ste 1100
Colorado Springs, CO 80903-2253

Mailing address

11001 Hammerly Blvd
Houston, TX 77043-1913
Phone (713) 467-4696

Other practice location 1

11001 Hammerly Blvd
Houston, TX 77043-1913
Phone (713) 467-4696 ext. 171

Other practice location 2

3800 N LaMar Blvd Ste 200
Austin, TX 78756-0003
Phone (512) 399-0064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221216000201 CO Practitioner - Qualified Speech Language Pathologist 4082083985 Reassigns benefits to 1 organization
I20221216000284 TX Practitioner - Qualified Speech Language Pathologist 4082083985 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111603TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Parish Children's School Speech-Language Pathologist Past Accepting new patients

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": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1760837454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 HAMMERLY BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770431913",
            "telephone_number": "713-467-4696",
            "fax_number": "713-467-8341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S TEJON ST STE 1100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809032253",
            "telephone_number": "512-399-0064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11001 Hammerly Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770431913",
            "country_code": "US",
            "telephone_number": "713-467-4696 x171",
            "fax_number": "713-467-8341",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3800 N LaMar Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787560003",
            "country_code": "US",
            "telephone_number": "512-399-0064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAHL",
        "first_name": "COURTNEY",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-29",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "111603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.