Individual provider Active NPI

Aubrey L. Stubler, MS CCC-SLP

  • Speech-Language Pathologist
  • Flagstaff, AZ
National Provider Identifier
1851818561
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP8439 Issued in AZ
Practice address
5130 N US Highway 89
Flagstaff, AZ 86004-2837
Phone
(928) 773-2054
NPI assigned
Aug 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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 SLP8439 AZ Primary

Addresses

Primary practice location

5130 N US Highway 89
Flagstaff, AZ 86004-2837

Mailing address

614 W Beal Road
Flagstaff, AZ 86001-3007
Phone (928) 779-1679

Other practice location 1

Northland-Rural Therapy Associates
2915 N. 4th Street
Flagstaff, AZ 86004
Phone (928) 779-1679

Other identifiers 1

IdentifierTypeStateIssuer
299761MedicaidAZ

Other names 1

  • Aubrey Brennecke Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181210001643 AZ Practitioner - Qualified Speech Language Pathologist 9032453543 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SLP8439AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Healthcare Corporation CurrentSince May 22, 2023 Accepting new patients
Northern Arizona Healthcare Corporation Current Accepting new patients

Locations

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

5130 N US Highway 89
Flagstaff, AZ 86004
Phone (928) 773-2054

Organizations & group practices 2

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": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1851818561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 W BEAL ROAD",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013007",
            "telephone_number": "928-779-1679",
            "fax_number": "928-779-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 N US HIGHWAY 89",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860042837",
            "telephone_number": "928-773-2054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Northland-Rural Therapy Associates",
            "address_2": "2915 N. 4th Street",
            "address_purpose": "LOCATION",
            "city": "Flagstaff",
            "state": "AZ",
            "postal_code": "86004",
            "country_code": "US",
            "telephone_number": "928-779-1679",
            "fax_number": "928-779-2822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUBLER",
        "first_name": "AUBREY",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP8439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "299761",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUBREY",
            "last_name": "BRENNECKE",
            "credential": "MS CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.