Individual provider Active NPI

Bridgett Karraker, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Phoenix, AZ
National Provider Identifier
1851950398
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP13677 Issued in AZ
Practice address
4350 E Ray Rd Ste 101a
Phoenix, AZ 85044-4707
Phone
(480) 704-5954
NPI assigned
Jun 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146014206 IL
Speech-Language Pathologist 235Z00000X SLP13677 AZ Primary

Addresses

Primary practice location

4350 E Ray Rd Ste 101a
Phoenix, AZ 85044-4707

Mailing address

4350 E Ray Rd
Phoenix, AZ 85044-4703
Phone (480) 704-5954

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
SLP13677AZMDSpeech-Language Pathologist
146014206ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Valley Pediatric Therapy CurrentSince Jun 26, 2022 Accepting new patients

Locations

4350 E Ray Rd
Ste 101A
Phoenix, AZ 85044
Phone (480) 704-5954

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": "1560038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1851950398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 E RAY RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444703",
            "telephone_number": "480-704-5954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 E RAY RD STE 101A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444707",
            "telephone_number": "480-704-5954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARRAKER",
        "first_name": "BRIDGETT",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-09",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146014206",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP13677",
            "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 Jun 20, 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.