Individual provider Active NPI

Marybeth Garrett Crowetipton

  • Speech-Language Pathologist
  • Lexington, SC
National Provider Identifier
1205466117
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7120 Issued in SC
Practice address
720 Old Cherokee Rd
Lexington, SC 29072-9406
Phone
(803) 490-0960
NPI assigned
Jan 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

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 7120 SC Primary

Addresses

Primary practice location

720 Old Cherokee Rd
Lexington, SC 29072-9406

Mailing address

720 Old Cherokee Rd
Lexington, SC 29072-9406
Phone (803) 490-0960

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

State licenses

LicenseStateTypeSpecialty
7120SCMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1205466117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 OLD CHEROKEE RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290729406",
            "telephone_number": "803-490-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 OLD CHEROKEE RD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290729406",
            "telephone_number": "803-490-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWETIPTON",
        "first_name": "MARYBETH",
        "middle_name": "GARRETT",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-20",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "7120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; 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.