Individual provider Active NPI

Phyllis S Forbes, M.S.,CCC-SLP

  • Speech-Language Pathologist
  • Burlington, VT
National Provider Identifier
1629291141
Registry record updated Jul 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
12095059 Issued in VT
Practice address
Pomeroy Hall 489 Main St
Burlington, VT 05405-0001
Phone
(802) 656-3861
NPI assigned
Apr 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 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 12095059 VT Primary

Addresses

Primary practice location

Pomeroy Hall 489 Main St
Burlington, VT 05405-0001

Mailing address

155 Lakewood Pkwy
Burlington, VT 05408-2726
Phone (802) 860-6606

Other names 1

  • Chrissy Forbes Other name

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
12095059VTMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217289600000",
    "number": "1629291141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 LAKEWOOD PKWY",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054082726",
            "telephone_number": "802-860-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "POMEROY HALL 489 MAIN ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054050001",
            "telephone_number": "802-656-3861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORBES",
        "first_name": "PHYLLIS",
        "middle_name": "S",
        "credential": "M.S.,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2008-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VT",
            "license": "12095059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISSY",
            "last_name": "FORBES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.