Individual provider Active NPI

Taylor Udall, C-SLPA

  • Speech-Language Assistant
  • Glendale, AZ
National Provider Identifier
1972277705
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SLPA12839 Issued in AZ
Practice address
4650 W Sweetwater Ave
Glendale, AZ 85304-1505
Phone
(602) 347-2600
NPI assigned
Aug 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 2355S0801X SLPA12839 AZ Primary

Addresses

Primary practice location

4650 W Sweetwater Ave
Glendale, AZ 85304-1505

Mailing address

4650 W Sweetwater Ave
Glendale, AZ 85304-1505

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SLPA12839AZMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1972277705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 W SWEETWATER AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SWEETWATER AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041505",
            "telephone_number": "602-347-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDALL",
        "first_name": "TAYLOR",
        "credential": "C-SLPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-04",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AZ",
            "license": "SLPA12839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.