Active NPI
Annette Cameron O'Connell, M.S., CCC-SLP
- Speech-Language Pathologist
- Kenai, AK
National Provider Identifier
1932241973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 63
- Practice address
- 110 Trading Bay Dr
Suite 105
Kenai, AK 99611-7716 - Phone
- (907) 283-4300
- Fax
- (907) 283-4362
- NPI assigned
- Feb 13, 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 | 63 | AK | Primary |
Addresses
Primary practice location
110 Trading Bay Dr
Suite 105
Kenai, AK 99611-7716
Mailing address
PO Box 3187
Kenai, AK 99611-3187
Phone (907) 283-4300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SP11532 | Medicaid | AK |
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63 | AK | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alaskas Speech & Language Clinic, Inc. | Speech-Language Pathologist | Current | Accepting new patients |
Locations
110 Trading Bay Rd
Ste 105
Kenai, AK 99611
Phone (907) 283-4300
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Speech-Language Pathologist
- Kenai, AK
- NPI 1568693117
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371081600000",
"number": "1932241973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3187",
"city": "KENAI",
"state": "AK",
"postal_code": "996113187",
"telephone_number": "907-283-4300",
"fax_number": "907-283-4362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 TRADING BAY DR",
"address_2": "SUITE 105",
"city": "KENAI",
"state": "AK",
"postal_code": "996117716",
"telephone_number": "907-283-4300",
"fax_number": "907-283-4362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'CONNELL",
"first_name": "ANNETTE",
"middle_name": "CAMERON",
"name_prefix": "Mrs.",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2013-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AK",
"license": "63",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SP11532",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kenai, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.