Active NPI
Suzan Marie Campbell, SLP
- Speech-Language Pathologist
- Wichita Falls, TX
National Provider Identifier
1740265271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 100444
- Practice address
- 1005 Midwestern Pkwy
Wichita Falls, TX 76302-2211 - Phone
- (940) 322-0771
- Fax
- (940) 766-4943
- NPI assigned
- Dec 7, 2005
- Sex
- Female
- Sole proprietor
- Yes
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 | 100444 | TX | Primary |
Addresses
Primary practice location
1005 Midwestern Pkwy
Wichita Falls, TX 76302-2211
Mailing address
1104 Broad St
Wichita Falls, TX 76301-4412
Phone (940) 235-1000
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100444 | Other | TX | HUMANA ID # |
| 125017 | Other | TN | SUPERIOR ID # |
| 0077279 | Other | TX | BLUE LINK# |
| 86857T | Other | TX | BCBS PROVIDER # |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 100444 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wichita Falls Isd | 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 and National Provider Directory roles.
-
- Local Education Agency (LEA)
- Wichita Falls, TX
- NPI 1841417904
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665964800000",
"number": "1740265271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1104 BROAD ST",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763014412",
"telephone_number": "940-235-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 MIDWESTERN PKWY",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763022211",
"telephone_number": "940-322-0771",
"fax_number": "940-766-4943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "SUZAN",
"middle_name": "MARIE",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-12-07",
"last_updated": "2022-10-17",
"certification_date": "2022-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "100444",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA ID #",
"identifier": "100444",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUPERIOR ID #",
"identifier": "125017",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE LINK#",
"identifier": "0077279",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER #",
"identifier": "86857T",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wichita Falls, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.