Organization Active NPI

Valley Speech LLC

  • Speech-Language Pathologist
  • Yuma, AZ
National Provider Identifier
1891415618
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
VALLEY SPEECH LLC
Practice address
2851 S Avenue B Lot 5
Yuma, AZ 85364-7726
Phone
(928) 750-6384
NPI assigned
Aug 31, 2022
Last updated
Oct 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Authorized official

Name
Justin Thomas Haile
Title
Owner
Phone
(928) 750-6384

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X NU Primary

Addresses

Primary practice location

2851 S Avenue B Lot 5
Yuma, AZ 85364-7726

Mailing address

300 W 22ND St
Yuma, AZ 85364-6428
Phone (928) 750-6384

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231019001262 AZ Part B Supplier - Clinic/Group Practice 0143676650 Receives reassigned benefits from 4 practitioners
Practice locations: Yuma, AZ

National Provider Directory

National Provider Directory

Locations

2851 S Avenue B
#5
Yuma, AZ 85364
Phone (928) 318-6422

2851 S Avenue B
Lot 5
Yuma, AZ 85364
Phone (928) 318-6422

300 W 22nd St
Yuma, AZ 85364

Practitioners & affiliated clinicians

Practitioners 6

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": "1661904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666310400000",
    "number": "1891415618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W 22ND ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853646428",
            "telephone_number": "928-750-6384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2851 S AVENUE B LOT 5",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647726",
            "telephone_number": "928-750-6384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY SPEECH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-18",
        "status": "A",
        "authorized_official_last_name": "HAILE",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-750-6384"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.