Individual provider Active NPI

Robert Chaires

  • Speech-Language Pathologist
  • Colorado Springs, CO
National Provider Identifier
1023534229
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
PSLP.0000392 Issued in CO
Practice address
5446 N Academy Blvd
Colorado Springs, CO 80918-3644
Phone
(719) 598-5555
NPI assigned
Aug 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NM
Speech-Language Pathologist 235Z00000X PSLP.0000392 CO Primary

Addresses

Primary practice location

5446 N Academy Blvd
Colorado Springs, CO 80918-3644

Mailing address

5446 N Academy Blvd
Colorado Springs, CO 80918-3644
Phone (719) 598-5555

Other practice location 1

1500 S Ave K
Station 3, SHROC
Portales, NM 88130
Phone (575) 562-2156

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240729004536 NM Practitioner - Qualified Speech Language Pathologist 4486191285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3900 Eubank Blvd NE
Suite 7
Albuquerque, NM 87111-3427
Phone (505) 463-6039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSLP.0000392COMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Therapy Spot LLC CurrentSince Jul 1, 2024 Accepting new patients
Eastern New Mexico University Speech-Language Pathologist PastSince Nov 12, 2023 Accepting new patients

Locations

3900 Eubank Blvd NE
Ste 7
Albuquerque, NM 87111
Phone (505) 461-3525

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1023534229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5446 N ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183644",
            "telephone_number": "719-598-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5446 N ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183644",
            "telephone_number": "719-598-5555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Ave K",
            "address_2": "Station 3, SHROC",
            "address_purpose": "LOCATION",
            "city": "Portales",
            "state": "NM",
            "postal_code": "88130",
            "country_code": "US",
            "telephone_number": "575-562-2156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAIRES",
        "first_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-18",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "PSLP.0000392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; 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.