Candace Baumgart Ibbotson

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

14287 Issued in TX

Practice address

600 Elizabeth Street
Corpus Christi, TX 78404

Phone

(361) 881-3518

NPI assigned

Apr 24, 2007

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

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Synergy Care Southeast, LLC

  dba Synergy Care Southeast LLC - Texas

  • Physical Therapist
  • Lake Charles, LA
  • NPI 1427466614

  Speech-Language Pathologist, TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083833560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 ABERDEEN AVE",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784111231",
            "telephone_number": "512-970-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ELIZABETH STREET",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "78404",
            "telephone_number": "361-881-3518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBBOTSON",
        "first_name": "CANDACE",
        "middle_name": "BAUMGART",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "14287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• I-Med
• Ibanez Internal Medicine
• Gabriela Ibarra
• Jordan M Ibarra, M.D.
• Makayla Ibarra
• Tesneem Ibrahim, MD
• Ideal Internal Medicine PLLC
• Donald L Iden, M.D.
• Eucharia C Igwe, PHARMD
• IHS Acquisition No 140 Inc (Harbor View Care Center)

• Speech-Language Pathologist in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.