Individual provider Active NPI

Darlene Crofcheck Cherney, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Gallup, NM
National Provider Identifier
1114058757
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3478 Issued in NM
Practice address
1000 E Aztec Ave
Gallup, NM 87301-5509
Phone
(505) 879-0866
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 3478 NM Primary

Addresses

Primary practice location

1000 E Aztec Ave
Gallup, NM 87301-5509

Mailing address

1125 Burke Dr
Gallup, NM 87301-5419
Phone (505) 722-6466

Other identifiers 1

IdentifierTypeStateIssuer
58934553MedicaidNM

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
3478NMMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1114058757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 BURKE DR",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015419",
            "telephone_number": "505-722-6466",
            "fax_number": "505-722-6380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E AZTEC AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015509",
            "telephone_number": "505-879-0866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERNEY",
        "first_name": "DARLENE",
        "middle_name": "CROFCHECK",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "3478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58934553",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.