Individual provider Active NPI

Pamela Gayle Canfield, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Liberty, MO
National Provider Identifier
1346404597
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2022020125 Issued in MO
Practice address
826 Blueberry LN
Liberty, MO 64068-1309
Phone
(913) 602-9670
NPI assigned
Jul 16, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2768 KS
Speech-Language Pathologist 235Z00000X 2022020125 MO Primary

Addresses

Primary practice location

826 Blueberry LN
Liberty, MO 64068-1309

Mailing address

826 Blueberry LN
Liberty, MO 64068-1309
Phone (913) 602-9670

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 Arts

State licenses

LicenseStateTypeSpecialty
2768KSMDProfessional Counselor
2022020125MOMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1346404597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 BLUEBERRY LN",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681309",
            "telephone_number": "913-602-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 BLUEBERRY LN",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681309",
            "telephone_number": "913-602-9670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANFIELD",
        "first_name": "PAMELA",
        "middle_name": "GAYLE",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-16",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KS",
            "license": "2768",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2022020125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.