Individual provider Active NPI

Leisha Vogl, CCC-SLP

  • Speech-Language Pathologist
  • Salem, OR
National Provider Identifier
1356698575
Registry record updated Dec 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
13361 Issued in OR
Practice address
1475 Capitol St NE
Salem, OR 97301-7850
Phone
(971) 599-1712
Fax
(888) 835-4257
NPI assigned
Aug 7, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2017

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 13361 OR Primary

Addresses

Primary practice location

1475 Capitol St NE
Salem, OR 97301-7850

Mailing address

PO Box 12381
Salem, OR 97309-0381
Phone (971) 599-1712

Other identifiers 1

IdentifierTypeStateIssuer
500684879MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180327000587 OR Practitioner - Qualified Speech Language Pathologist 8921360348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sensible Speech-Language Pathology, IncGroup PAC ID 7012279433, 4 clinicians

Practice addresses (Care Compare)

1475 Capitol St NE
Salem, OR 97301-7850
Phone (971) 599-1712

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13361ORMDMassage Therapist

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.

NPI Registry JSON

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513728000000",
    "number": "1356698575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12381",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973090381",
            "telephone_number": "971-599-1712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 CAPITOL ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973017850",
            "telephone_number": "971-599-1712",
            "fax_number": "888-835-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOGL",
        "first_name": "LEISHA",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-07",
        "last_updated": "2017-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "13361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500684879",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.