Active NPI
Mark M Guiberson, PH.D.
- Speech-Language Pathologist
- Greeley, CO
National Provider Identifier
1669666897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 12009231
- Practice address
- Unc Speech and Audiology Clinic
Gunter Hall Room 0330
Greeley, CO 80639 - Phone
- (970) 351-2012
- NPI assigned
- Aug 30, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 12009231 | CO | Primary |
Addresses
Primary practice location
Unc Speech and Audiology Clinic
Gunter Hall Room 0330
Greeley, CO 80639
Mailing address
1631 Remington St
Fort Collins, CO 80525-1358
Phone (970) 218-6433
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12009231 | CO | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188432000000",
"number": "1669666897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1631 REMINGTON ST",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805251358",
"telephone_number": "970-218-6433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "UNC SPEECH AND AUDIOLOGY CLINIC",
"address_2": "GUNTER HALL ROOM 0330",
"city": "GREELEY",
"state": "CO",
"postal_code": "80639",
"telephone_number": "970-351-2012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUIBERSON",
"first_name": "MARK",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-30",
"last_updated": "2007-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CO",
"license": "12009231",
"primary": true
}
],
"identifiers": [],
"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 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.