Individual provider Active NPI

Robert Smith

  • Speech-Language Assistant
  • Buckeye, AZ
National Provider Identifier
1962734863
Registry record updated Feb 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
6498 Issued in AZ
Practice address
19871 W Freemont Rd
Buckeye, AZ 85326-9512
Phone
(623) 474-6671
NPI assigned
Feb 3, 2010
Last updated
Feb 5, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 6498 AZ Primary

Addresses

Primary practice location

19871 W Freemont Rd
Buckeye, AZ 85326-9512

Mailing address

7638 W Orangewood Ave
Glendale, AZ 85303-1517

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190328002082 AZ Practitioner - Qualified Speech Language Pathologist 8123368149 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6498AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Theraplay4Kidz, LLC Speech-Language Pathologist CurrentSince Aug 1, 2019 Accepting new patients
Theracare PLLC Speech-Language Pathologist CurrentSince Mar 1, 2020 Accepting new patients
Arion Care Solutions, LLC PastSince Sep 1, 2019 Accepting new patients
Heartland Therapy, Inc. Past Accepting new patients

Locations

530 E McDowell Rd
Ste 107495
Phoenix, AZ 85004

9525 E Doubletree Ranch Rd
Ste 101
Scottsdale, AZ 85258
Phone (480) 488-3946

Organizations & group practices 4

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": "1265155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265328000000",
    "number": "1962734863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7638 W ORANGEWOOD AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853031517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19871 W FREEMONT RD",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853269512",
            "telephone_number": "623-474-6671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-03",
        "last_updated": "2010-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "6498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buckeye, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2010; 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.