Individual provider Active NPI

Sherry Bagwell, SLP-CCC

  • Speech-Language Pathologist
  • Clarksville, TN
National Provider Identifier
1609296938
Registry record updated Apr 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
621 Gracey Ave
Clarksville, TN 37040-4012
Phone
(423) 622-1551
Fax
(877) 856-7133
NPI assigned
Apr 25, 2014
Last updated
Apr 25, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2014

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 NU Primary

Addresses

Primary practice location

621 Gracey Ave
Clarksville, TN 37040-4012

Mailing address

PO Box 8114
Chattanooga, TN 37414-0114
Phone (423) 622-1551

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clarksville-Montgomery County School System Past Accepting new patients

Organizations & group practices 1

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": "1398384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398384000000",
    "number": "1609296938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8114",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374140114",
            "telephone_number": "423-622-1551",
            "fax_number": "877-856-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 GRACEY AVE",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370404012",
            "telephone_number": "423-622-1551",
            "fax_number": "877-856-7133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGWELL",
        "first_name": "SHERRY",
        "credential": "SLP-CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-25",
        "last_updated": "2014-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2014; 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.