NPIMap

Organization Active NPI

Michael Allen Douglas & Kimberli C Douglas Bounce Back Speech Therapy

  • Home Health Agency
  • Gilbert, AZ
National Provider Identifier
1881894202
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
SLP5027 Issued in AZ
Legal business name
MICHAEL ALLEN DOUGLAS & KIMBERLI C DOUGLAS BOUNCE BACK SPEECH THERAPY
Practice address
1950 E Lafayette Ave
Gilbert, AZ 85298-0821
Phone
(480) 274-3951
Fax
(480) 718-7987
NPI assigned
Jul 23, 2007
Last updated
Jan 23, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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

Authorized official

Name
Kimberli Douglas, MA, CCC-SLPNPI 1700946100
Title
Owner
Phone
(480) 274-3951

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X SLP5027 AZ Primary

Addresses

Primary practice location

1950 E Lafayette Ave
Gilbert, AZ 85298-0821

Mailing address

1950 E Lafayette Ave
Gilbert, AZ 85298-0821
Phone (480) 274-3951

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358899200000",
    "number": "1881894202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 E LAFAYETTE AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852980821",
            "telephone_number": "480-274-3951",
            "fax_number": "480-718-7987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 E LAFAYETTE AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852980821",
            "telephone_number": "480-274-3951",
            "fax_number": "480-718-7987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL ALLEN DOUGLAS & KIMBERLI C DOUGLAS BOUNCE BACK SPEECH THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2013-01-23",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "KIMBERLI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-274-3951",
        "authorized_official_credential": "MA, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AZ",
            "license": "SLP5027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; 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.