Individual provider Active NPI

Carmela Lucia Champ, MS CCC-SLP

  • Speech-Language Pathologist
  • York, PA
National Provider Identifier
1114016490
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL006263L Issued in PA
Practice address
3995 E Market St
York, PA 17402-2773
Phone
(717) 757-1227
Fax
(717) 757-1353
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 SL006263L PA Primary

Addresses

Primary practice location

3995 E Market St
York, PA 17402-2773

Mailing address

6400 Deer Run CT
Spring Grove, PA 17362-8221
Phone (717) 341-3394

Other identifiers 1

IdentifierTypeStateIssuer
0019268510003OtherPAMA-PROMISE

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SL006263LPAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114016490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 DEER RUN CT",
            "city": "SPRING GROVE",
            "state": "PA",
            "postal_code": "173628221",
            "telephone_number": "717-341-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3995 E MARKET ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022773",
            "telephone_number": "717-757-1227",
            "fax_number": "717-757-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMP",
        "first_name": "CARMELA",
        "middle_name": "LUCIA",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL006263L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MA-PROMISE",
            "identifier": "0019268510003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.