Individual provider Active NPI

Cheryl Annette Branscum, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Bay Minette, AL
National Provider Identifier
1104908920
Registry record updated Jun 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3661 Issued in AL
Practice address
2115 Hand Ave
Bay Minette, AL 36507-4149
Phone
(251) 937-2823
Fax
(251) 937-2821
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP#1342 AR
Speech-Language Pathologist 235Z00000X 3661 AL Primary

Addresses

Primary practice location

2115 Hand Ave
Bay Minette, AL 36507-4149

Mailing address

8839 Bainbridge Dr
Daphne, AL 36526-8331
Phone (501) 733-5270

Other identifiers 1

IdentifierTypeStateIssuer
141346721MedicaidAR

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 Arts

State licenses

LicenseStateTypeSpecialty
3661ALMDEndodontist
SP#1342ARMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435104000000",
    "number": "1104908920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8839 BAINBRIDGE DR",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365268331",
            "telephone_number": "501-733-5270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 HAND AVE",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "365074149",
            "telephone_number": "251-937-2823",
            "fax_number": "251-937-2821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANSCUM",
        "first_name": "CHERYL",
        "middle_name": "ANNETTE",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2015-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP#1342",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": "3661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141346721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Minette, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; 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.