Individual provider Active NPI

Connie T Rugolo, MS/CCC-LP

  • Speech-Language Pathologist
  • Phoenix, AZ
National Provider Identifier
1942266093
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP1770 Issued in AZ
Practice address
3141 N 3Rd Ave Ste 100
Phoenix, AZ 85013-4351
Phone
(602) 914-1594
NPI assigned
Apr 25, 2006
Last updated
May 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 5392 MN
Speech-Language Pathologist 235Z00000X SLP1770 AZ Primary

Addresses

Primary practice location

3141 N 3Rd Ave Ste 100
Phoenix, AZ 85013-4351

Mailing address

2929 E Thomas Rd
Phoenix, AZ 85016-8034
Phone (602) 470-5000

Other practice location 1

9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841
Phone (763) 780-9155

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191127002219 AZ Practitioner - Qualified Speech Language Pathologist 2062845316 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5392MNMDOrthopedic Physical Therapist
SLP1770AZMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Sep 21, 2019 Accepting new patients
District Medical Group, Inc CurrentSince Sep 21, 2019 Accepting new patients
District Medical Group, Inc Current Accepting new patients

Locations

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

3141 N 3rd Ave
Ste 100
Phoenix, AZ 85013
Phone (602) 914-1520

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1942266093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168034",
            "telephone_number": "602-470-5000",
            "fax_number": "602-470-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3141 N 3RD AVE STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134351",
            "telephone_number": "602-914-1594"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9055 Springbrook Dr NW",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554335841",
            "country_code": "US",
            "telephone_number": "763-780-9155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUGOLO",
        "first_name": "CONNIE",
        "middle_name": "T",
        "credential": "MS/CCC-LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "5392",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP1770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; 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.