Individual provider Active NPI

Elizabeth Gangware, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Boulder, CO
National Provider Identifier
1376417550
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP.0006565 Issued in CO
Practice address
6640 Gunpark Dr Ste 102
Boulder, CO 80301-7001
Phone
(303) 530-9191
NPI assigned
Oct 1, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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 SLP.0006565 CO Primary

Addresses

Primary practice location

6640 Gunpark Dr Ste 102
Boulder, CO 80301-7001

Mailing address

6640 Gunpark Dr Ste 102
Boulder, CO 80301-7001
Phone (303) 530-9191

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
SLP.0006565COMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1759276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1376417550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6640 GUNPARK DR STE 102",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803017001",
            "telephone_number": "303-530-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6640 GUNPARK DR STE 102",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803017001",
            "telephone_number": "303-530-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGWARE",
        "first_name": "ELIZABETH",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-01",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "SLP.0006565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; 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.