Active NPI
Crystal Walters
- Speech-Language Pathologist
- Lakewood, CO
National Provider Identifier
1366617227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3020
- Practice address
- 1625 S Cape St
Lakewood, CO 80232-6609 - Phone
- (720) 841-3051
- NPI assigned
- Apr 22, 2008
- Last updated
- Jan 31, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 12083447 | CO | |
| Speech-Language Pathologist | 235Z00000X | 3020 | KS | Primary |
Addresses
Primary practice location
1625 S Cape St
Lakewood, CO 80232-6609
Mailing address
1625 S Cape St
Lakewood, CO 80232-6609
Phone (720) 841-3051
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3020 | KS | MD | Social Worker |
| 12083447 | CO | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548892800000",
"number": "1366617227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1625 S CAPE ST",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "802326609",
"telephone_number": "720-841-3051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1625 S CAPE ST",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "802326609",
"telephone_number": "720-841-3051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTERS",
"first_name": "CRYSTAL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-22",
"last_updated": "2019-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CO",
"license": "12083447",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "KS",
"license": "3020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.