Individual provider Active NPI

Babbette Skipper, SLP

  • Speech-Language Pathologist
  • Vicksburg, MS
National Provider Identifier
1497834287
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
S0682 Issued in MS
Practice address
1901 Mission 66
Suite a
Vicksburg, MS 39180-3711
Phone
(601) 638-4076
Fax
(601) 638-4979
NPI assigned
Nov 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 S0682 MS Primary

Addresses

Primary practice location

1901 Mission 66
Suite a
Vicksburg, MS 39180-3711

Mailing address

PO Box 822394
Vicksburg, MS 39182-2394
Phone (601) 638-4076

Other identifiers 1

IdentifierTypeStateIssuer
07789524MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170615002586 MS Practitioner - Qualified Speech Language Pathologist 0143503490 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S0682MSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Performance and Rehab, LLC CurrentSince Feb 1, 2017 Accepting new patients
Spark Therapy, LLC Speech-Language Pathologist Current Accepting new patients
Good Samaritan Physical Therapy,Inc. Past Accepting new patients
Diagnostic Testing Solutions Past Accepting new patients

Locations

2080 S Frontage Rd
Ste 108
Vicksburg, MS 39180
Phone (601) 629-4304

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497834287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 822394",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391822394",
            "telephone_number": "601-638-4076",
            "fax_number": "601-638-4979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 MISSION 66",
            "address_2": "SUITE A",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391803711",
            "telephone_number": "601-638-4076",
            "fax_number": "601-638-4979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKIPPER",
        "first_name": "BABBETTE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S0682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07789524",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.