Individual provider Active NPI

Connie Perkins-Green, SLP

  • Speech-Language Pathologist
  • Albuquerque, NM
National Provider Identifier
1871626044
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1297 Issued in NM
Practice address
6504 Harper Dr NE
Arroyo del Oso Es
Albuquerque, NM 87109-3604
Phone
(505) 821-9393
NPI assigned
Mar 14, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 1297 NM Primary

Addresses

Primary practice location

6504 Harper Dr NE
Arroyo del Oso Es
Albuquerque, NM 87109-3604

Mailing address

6504 Harper Dr NE
Arroyo del Oso Es
Albuquerque, NM 87109-3604
Phone (505) 821-9393

Other identifiers 1

IdentifierTypeStateIssuer
L 0938MedicaidNM

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

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1871626044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6504 HARPER DR NE",
            "address_2": "ARROYO DEL OSO ES",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093604",
            "telephone_number": "505-821-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6504 HARPER DR NE",
            "address_2": "ARROYO DEL OSO ES",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093604",
            "telephone_number": "505-821-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKINS-GREEN",
        "first_name": "CONNIE",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "1297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L 0938",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.