Active NPI
Jacob Tryon
- Speech-Language Assistant
- Goodyear, AZ
National Provider Identifier
1831470335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SLPA7229
- Practice address
- 500 N Bullard Ave
#27
Goodyear, AZ 85338-2533 - Phone
- (623) 986-5110
- NPI assigned
- Aug 30, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | SLPA7229 | AZ | Primary |
Addresses
Primary practice location
500 N Bullard Ave
#27
Goodyear, AZ 85338-2533
Mailing address
500 N Bullard Ave
#27
Goodyear, AZ 85338-2533
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLPA7229 | AZ | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eleutheria, LLC | Speech-Language Assistant | Past | Accepting new patients |
Organizations & group practices 1
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": "1314662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314662400000",
"number": "1831470335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 N BULLARD AVE",
"address_2": "#27",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853382533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 N BULLARD AVE",
"address_2": "#27",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853382533",
"telephone_number": "623-986-5110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRYON",
"first_name": "JACOB",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-30",
"last_updated": "2011-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "AZ",
"license": "SLPA7229",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goodyear, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.