Erin Standefer, MSCCCSLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5979 Issued in NM

Practice address

1225 Libra Dr
Portales, NM 88130-6125

Phone

(575) 309-3434

NPI assigned

Jul 13, 2016

Sex

Male

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

• Erin Burnworth Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• SP Speech Therapy

  • Speech-Language Pathologist
  • Clovis, NM
  • NPI 1730965724
  NPD Authorized official
• Eastern New Mexico University

  dba ENMU Sports Medicine

  • Speech-Language Pathologist
  • Portales, NM
  • NPI 1053794727
  NPD

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1114379229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 LIBRA DR",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881306125",
            "telephone_number": "575-309-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 LIBRA DR",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881306125",
            "telephone_number": "575-309-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANDEFER",
        "first_name": "ERIN",
        "credential": "MSCCCSLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-13",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "5979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "BURNWORTH",
            "credential": "MS CCC SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Desiree I Smith, RN
• James Franklin Smith, DDS
• Makenzie Marie Smith
• William J. Smith, DC., CCST
• Southeastern Behavioral Associates, LLC
• Aaron Mark Standing, DMD
• Jordan Stearns
• Sheila Ann Stephenson, LCSW
• Ana Stotlemeyer
• Michael B Stull, IDMT

• Speech-Language Pathologist in Portales, NM
• Providers in Portales, NM by specialty
• Speech-Language Pathologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.