Individual provider Active NPI

Samantha Welch

  • Speech-Language Pathologist
  • Phoenix, AZ
National Provider Identifier
1821875527
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
14308378 Issued in AZ
Practice address
20860 N Tatum Blvd Ste 300
Phoenix, AZ 85050-4283
Phone
(847) 751-0045
Fax
(415) 358-4808
NPI assigned
Sep 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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 14308378 AZ Primary

Addresses

Primary practice location

20860 N Tatum Blvd Ste 300
Phoenix, AZ 85050-4283

Mailing address

1035 Detroit St
Denver, CO 80206-3325
Phone (623) 692-7400

Other practice location 1

4650 Central Park Blvd
Denver, CO 80238-2328
Phone (623) 692-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231122000076 CO Practitioner - Qualified Speech Language Pathologist 8325496821 Reassigns benefits to 2 organizations
I20241108003471 AZ Practitioner - Qualified Speech Language Pathologist 8325496821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hona Medical Group PAGroup PAC ID 9032641113, 7 clinicians

Practice addresses (Care Compare)

20860 N Tatum Blvd
Suite 300
Phoenix, AZ 85050-4283
Phone (847) 751-0045

7535 E Hampden Ave
Suite 400
Denver, CO 80231-4844
Phone (847) 751-0045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14308378AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Oct 2, 2023 Accepting new patients
Hona Medical Group PA Speech-Language Pathologist CurrentSince Aug 26, 2024 Accepting new patients
Legacy Healthcare Services Inc. Speech-Language Pathologist CurrentSince Oct 2, 2023 Accepting new patients

Locations

20860 N Tatum Blvd
Ste 300
Phoenix, AZ 85050
Phone (480) 478-0520

7535 E Hampden Ave
Ste 400
Denver, CO 80231
Phone (303) 229-6393

6303 Waterford District Dr
Ste 400
Miami, FL 33126
Phone (786) 801-1571

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

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": "1694649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1821875527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 DETROIT ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802063325",
            "telephone_number": "623-692-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20860 N TATUM BLVD STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504283",
            "telephone_number": "847-751-0045",
            "fax_number": "415-358-4808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4650 Central Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802382328",
            "country_code": "US",
            "telephone_number": "623-692-7400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELCH",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-14",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "14308378",
            "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 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.