Individual provider Active NPI

Cheryl R Campbell, CCC-SLP

  • Speech-Language Pathologist
  • Greeley, CO
National Provider Identifier
1669475828
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP.0003021 Issued in CO
Practice address
1175 58TH Ave Ste 101
Greeley, CO 80634
Phone
(970) 682-3743
NPI assigned
May 23, 2005
Last updated
Aug 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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 SLP.0003021 CO Primary

Addresses

Primary practice location

1175 58TH Ave Ste 101
Greeley, CO 80634

Mailing address

1175 58TH Ave Ste 101
Greeley, CO 80634-4808
Phone (970) 460-8708

Other practice location 1

3500 LaTouche St Ste 350
Anchorage, AK 99508-4261
Phone (907) 522-0078

Other identifiers 1

IdentifierTypeStateIssuer
SP48701MedicaidAK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191016003242 CO Practitioner - Qualified Speech Language Pathologist 5193056505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SLP.0003021COMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aspen Speech Therapy and Rehabilitation LLC Speech-Language Pathologist CurrentSince Sep 1, 2019 Accepting new patients
Aspen Speech Therapy and Rehabilitation LLC Speech-Language Pathologist Current Accepting new patients
Aspen Speech Therapy and Rehabilitation LLC Speech-Language Pathologist CurrentSince Sep 1, 2019 Accepting new patients

Locations

1136 E Stuart St
Ste 3120
Fort Collins, CO 80525
Phone (970) 682-3743

1200 E Elizabeth St
Fort Collins, CO 80524
Phone (970) 416-6286

1175 58th Ave
Ste 101
Greeley, CO 80634
Phone (970) 495-0444

Organizations & group practices 3

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1669475828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 58TH AVE STE 101",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806344808",
            "telephone_number": "970-460-8708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 58TH AVE STE 101",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "80634",
            "telephone_number": "970-682-3743"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 LaTouche St Ste 350",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995084261",
            "country_code": "US",
            "telephone_number": "907-522-0078",
            "fax_number": "907-279-0331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "CHERYL",
        "middle_name": "R",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-23",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "SLP.0003021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SP48701",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; 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.