Individual provider Active NPI

Sarah Simrell

  • Speech-Language Pathologist
  • Tigard, OR
National Provider Identifier
1255926622
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
016675 Issued in OR
Practice address
13333 SW 68TH Pkwy Ste 20
Tigard, OR 97223-9354
Phone
(503) 352-0240
NPI assigned
Mar 7, 2021
Last updated
Dec 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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 016675 OR Primary

Addresses

Primary practice location

13333 SW 68TH Pkwy Ste 20
Tigard, OR 97223-9354

Mailing address

1728 NE 15TH Ave
Canby, OR 97013-2380
Phone (360) 649-5715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220228000598 OR Practitioner - Qualified Speech Language Pathologist 8325432834 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016675ORMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunbreak Therapy Services, Inc Speech-Language Pathologist CurrentSince Feb 14, 2022 Accepting new patients

Locations

366 N Holly St
Canby, OR 97013
Phone (503) 266-1030

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1615075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1255926622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1728 NE 15TH AVE",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970132380",
            "telephone_number": "360-649-5715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13333 SW 68TH PKWY STE 20",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972239354",
            "telephone_number": "503-352-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMRELL",
        "first_name": "SARAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-07",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "016675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.