Theresa Campeggio Sergotick, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

19801 N Creek Pkwy
Suite 200
Bothell, WA 98011-8240

Phone

(425) 984-2655

NPI assigned

Mar 20, 2017

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

• Theresa Claire Campeggio Former name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Seattle Children'S Hospital

  • Specialist
  • Seattle, WA
  • NPI 1003319500
  Medicare reassignment NPD
• Seattle Children'S Hospital

  • Children's Hospital
  • Seattle, WA
  • NPI 1467536276
  NPD
• Seattle Childrens Hospital

  • Clinic Pharmacy
  • Seattle, WA
  • NPI 1245342153
  NPD
• Seattle Children'S Hospital

  • Home Infusion Agency
  • Bothell, WA
  • NPI 1245383348
  NPD (past)

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1073054243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19801 N CREEK PKWY",
            "address_2": "SUITE 200",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980118240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19801 N CREEK PKWY",
            "address_2": "SUITE 200",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980118240",
            "telephone_number": "425-984-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERGOTICK",
        "first_name": "THERESA",
        "middle_name": "CAMPEGGIO",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-20",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "CAMPEGGIO",
            "middle_name": "CLAIRE",
            "credential": "MS, CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Natalee Sellers, DPT
• Ashton Sells
• Michelle Rene Sells, LSWAIC
• Haylie Semays, LMP
• Kelli Deanne Senger
• Steven Richard Sesso, RPH
• Kelsey Sevrens
• Nicole Marie Seward, PHARMD
• Aloka Hemant Shah
• Josefin Kristin Shakya, PT

• Speech-Language Pathologist in Bothell, WA
• Providers in Bothell, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; 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.