Individual provider Active NPI

Erica Shawn Boals, MS-CCC-SLP

  • Speech-Language Pathologist
  • Colorado Springs, CO
National Provider Identifier
1508028887
Registry record updated Jun 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
09131120 Issued in CO
Practice address
1685 S 21St St
Colorado Springs, CO 80904-5123
Phone
(719) 329-1774
NPI assigned
Jun 27, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2008

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 09131120 CO Primary

Addresses

Primary practice location

1685 S 21St St
Colorado Springs, CO 80904-5123

Mailing address

14220 Timberedge LN
Colorado Springs, CO 80921-2956

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

LicenseStateTypeSpecialty
09131120COMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1508028887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14220 TIMBEREDGE LN",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809212956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 S 21ST ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809045123",
            "telephone_number": "719-329-1774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOALS",
        "first_name": "ERICA",
        "middle_name": "SHAWN",
        "name_prefix": "Mrs.",
        "credential": "MS-CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-27",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "09131120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.