Bethany Jane McCracken, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

805 Walter St SE
Albuquerque, NM 87102-4247

Phone

(505) 901-2572

NPI assigned

Oct 21, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1417610916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 WALTER ST SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871024247",
            "telephone_number": "505-901-2572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 WALTER ST SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871024247",
            "telephone_number": "505-901-2572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRACKEN",
        "first_name": "BETHANY",
        "middle_name": "JANE",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-21",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "bethanyjmccracken@gmail.com",
            "affiliation": "N",
            "address_1": "805 Walter St SE",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871024247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Juliette Katrina McCoy, LCSW
• Pamela Walton McCoy, PHARMD
• Sharon M McCoy
• Stephani McCoy
• Wayne Donnie McCoy, D.D.S.
• C McCracken, PHARMD PHC BCPS
• David P McCraney, M.D.
• Alec McCranie, MD
• Cameron Dean McCraw, DO
• Emma Jean McCray

• Speech-Language Pathologist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Speech-Language Pathologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.