Active NPI
Patricia Tieszen, SLP
- Speech-Language Pathologist
- Albuquerque, NM
National Provider Identifier
1881725018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1390
- Practice address
- 9717 Indian School Rd NE
Eubank Es
Albuquerque, NM 87112-2956 - Phone
- (505) 299-4483
- NPI assigned
- Mar 8, 2007
- Sex
- Female
- 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 Pathologist | 235Z00000X | 1390 | NM | Primary |
Addresses
Primary practice location
9717 Indian School Rd NE
Eubank Es
Albuquerque, NM 87112-2956
Mailing address
9717 Indian School Rd NE
Eubank Es
Albuquerque, NM 87112-2956
Phone (505) 299-4483
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| K 5936 | Medicaid | NM |
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 |
|---|---|---|---|
| 1390 | NM | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1881725018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9717 INDIAN SCHOOL RD NE",
"address_2": "EUBANK ES",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871122956",
"telephone_number": "505-299-4483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9717 INDIAN SCHOOL RD NE",
"address_2": "EUBANK ES",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871122956",
"telephone_number": "505-299-4483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIESZEN",
"first_name": "PATRICIA",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-08",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NM",
"license": "1390",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "K 5936",
"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.