Individual provider Active NPI

Jennifer Leigh Campbell, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Roswell, NM
National Provider Identifier
1063566115
Registry record updated Jul 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2174 Issued in NM
Practice address
804 N. Union
Roswell, NM 88201
Phone
(575) 624-2095
Fax
(575) 627-5721
NPI assigned
Jan 23, 2007
Last updated
Jul 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2174 NM Primary

Addresses

Primary practice location

804 N. Union
Roswell, NM 88201

Mailing address

#9 N. Sycamore Court
Roswell, NM 88201-0618
Phone (575) 624-2095

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)
Enrolled
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1063566115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "#9 N. SYCAMORE COURT",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882010618",
            "telephone_number": "575-624-2095",
            "fax_number": "575-627-5721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 N. UNION",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "88201",
            "telephone_number": "575-624-2095",
            "fax_number": "575-627-5721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JENNIFER",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "2174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2012; 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.