Desiree Meredith

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP11095 Issued in AZ

Practice address

5750 W Thunderbird Rd Ste 500
Glendale, AZ 85306-4669

Phone

(623) 986-0887

NPI assigned

Mar 26, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Desiree Logan Former name

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Amy Grulke PLLCGroup PAC ID 4284992538, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Amy Grulke, PLLC

  • Speech-Language Pathologist
  • Chandler, AZ
  • NPI 1316464795
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1942705660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 N DOBSON RD STE 3",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852241819",
            "telephone_number": "623-986-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 W THUNDERBIRD RD STE 500",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064669",
            "telephone_number": "623-986-0887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEREDITH",
        "first_name": "DESIREE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP11095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DESIREE",
            "last_name": "LOGAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daisy Menjivar
• Mental Health Wellness Boutique
• Alexander Ian Meraz, MD
• Brenda Alina Mercado-Tarango, DPT
• Anthony Mercado
• Stacy-Ann Marie Meredith, LMSW
• Debra L Merrifield, PSY.D.
• Anthony Patterson Merrill, DO
• Alison N Merritt, PT
• Gerald Merritt IV, DPM

• Speech-Language Pathologist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.