Fusion Therapies PLLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

SLP4344 Issued in AZ

Legal business name

FUSION THERAPIES PLLC

Practice address

7747 W Deer Valley Rd Ste 255
Peoria, AZ 85382-2124

Phone

(623) 256-1728

NPI assigned

Dec 15, 2011

Organization subpart

No

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

Authorized official

Name

Kelly Jenkins, MHS, CCC-SLP

Title

Speech Language Pathologist

Phone

(623) 256-1728

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1323907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323907200000",
    "number": "1871862151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17333 W DURANGO ST",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853381704",
            "telephone_number": "623-256-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7747 W DEER VALLEY RD STE 255",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853822124",
            "telephone_number": "623-256-1728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUSION THERAPIES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-15",
        "last_updated": "2011-12-15",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "623-256-1728",
        "authorized_official_credential": "MHS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "AZ",
            "license": "SLP4344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.

Verify at the official NPI Registry.