Innovative Speech Therapy, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP4771 Issued in AZ

Legal business name

INNOVATIVE SPEECH THERAPY, LLC

Practice address

2017 W Tallgrass TRL
Phoenix, AZ 85085-2795

Phone

(602) 703-0613

NPI assigned

Jul 9, 2008

Last updated

Jul 9, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Angela Nicole Heaton, M.S., CCC-SLPNPI 1588746614

Title

Co-President

Phone

(602) 703-0613

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Angela Heaton, MS, CCC-SLP

  • Speech-Language Pathologist
  • Scottsdale, AZ
  • NPI 1588746614
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1821251810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 W TALLGRASS TRL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850852795",
            "telephone_number": "602-703-0613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 W TALLGRASS TRL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850852795",
            "telephone_number": "602-703-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE SPEECH THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-09",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "HEATON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "CO-PRESIDENT",
        "authorized_official_telephone_number": "602-703-0613",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP4771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Insight Counseling & Wellness Arizona LLC
• Insight Health Corp (INSIGHT IMAGING - Thomas Road)

• Speech-Language Pathologist in Phoenix, AZ
• Providers in Phoenix, 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 Jul 9, 2008; 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.