Nicole Padilla – Speech-Language Pathologist

Key facts

NPI: 1346605482
Entity type: Individual (NPI type 1)
Primary specialty: Speech-Language Pathologist 235Z00000X
License: CF7332 (NM)
Practice address: 1600 Sutter PL
Clovis, NM 88101-4611
Phone: (575) 769-4490
NPI assigned: Dec 16, 2015
Sex: Female
Sole proprietor: No

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 and National Provider Directory roles.

Eastern New Mexico University Speech-Language Pathologist · Portales, NM · NPI 1356115273

NPD (past) SPEECH-LANGUAGE PATHOLOGIST

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
CF7332	NM	MD	Speech-Language Pathologist

Practice roles

Organization	Specialty	Status	New patients
Eastern New Mexico University	Speech-Language Pathologist	Past since Nov 12, 2023	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Speech-Language Pathologist	235Z00000X	CF7332	NM	Yes

Addresses

Primary practice location

1600 Sutter PL
Clovis, NM 88101-4611

Mailing address

1600 Sutter PL
Clovis, NM 88101-4611
Phone (575) 769-4490

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 19, 2021.

{
    "created_epoch": "1450224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1346605482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SUTTER PL",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881014611",
            "telephone_number": "575-769-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SUTTER PL",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881014611",
            "telephone_number": "575-769-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADILLA",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-16",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "CF7332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, NM

All providers in Clovis, NM · Speech-Language Pathologist in New Mexico

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.