Individual provider Active NPI

Stephanie Holmstrom, MA CCC SLP

  • Speech-Language Pathologist
  • Denver, CO
National Provider Identifier
1922667922
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
0000756 Issued in CO
Practice address
777 Bannock St # B146
Denver, CO 80204-4507
Phone
(303) 602-1588
NPI assigned
Jun 12, 2019
Last updated
Jun 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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 0000756 CO Primary

Addresses

Primary practice location

777 Bannock St # B146
Denver, CO 80204-4507

Mailing address

777 Bannock St
Denver, CO 80204-4507

Other identifiers 1

IdentifierTypeStateIssuer
0000756OtherCODORA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stephanie.holmstrom@dhha.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220608000531 CO Practitioner - Qualified Speech Language Pathologist 7719365444 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
0000756COMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Apr 1, 2022 Accepting new patients
Denver Health and Hospital Authority CurrentSince Apr 1, 2022 Accepting new patients
Denver Health and Hospital Authority Past Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

777 Bannock St
#B146
Denver, CO 80204
Phone (303) 602-1588

777 Bannock St
Ste MC3450
Denver, CO 80204

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1922667922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST # B146",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044507",
            "telephone_number": "303-602-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMSTROM",
        "first_name": "STEPHANIE",
        "credential": "MA CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "0000756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORA",
            "identifier": "0000756",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stephanie.holmstrom@dhha.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "777 Bannock St # B146",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802044507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; 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.