Individual provider Active NPI

Anna Marie Koelzer, MA, CCC-SLP

  • Speech-Language Pathologist
  • San Francisco, CA
National Provider Identifier
1760974091
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
14297933
Practice address
180 Montgomery St Ste 1850
San Francisco, CA 94104-4278
Phone
(832) 930-3105
NPI assigned
Jun 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 31960 CA
Speech-Language Pathologist 235Z00000X 1809 ND
Speech-Language Pathologist 235Z00000X 113421 TX
Speech-Language Pathologist 235Z00000X 14297933 Primary

Addresses

Primary practice location

180 Montgomery St Ste 1850
San Francisco, CA 94104-4278

Mailing address

108 1St Ave SE
Minot, ND 58701-3926
Phone (832) 930-3105

Other names 1

  • Ms. Anna Marie Sanderford Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1809NDMDSpeech-Language Pathologist
113421TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1760974091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 1ST AVE SE",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587013926",
            "telephone_number": "832-930-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 MONTGOMERY ST STE 1850",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941044278",
            "telephone_number": "832-930-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOELZER",
        "first_name": "ANNA MARIE",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-01",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "31960",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "1809",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "113421",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "14297933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA MARIE",
            "last_name": "SANDERFORD",
            "prefix": "MS.",
            "credential": "MA, CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.