Individual provider Active NPI

Deborah Registrato Campbell, PHD,CCC-SLP

  • Speech-Language Pathologist
  • Crystal River, FL
National Provider Identifier
1740278142
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA0003586 Issued in FL
Practice address
315 NE 10TH Ave
Crystal River, FL 34429-4456
Phone
(352) 795-7006
Fax
(352) 795-7008
NPI assigned
Oct 10, 2005
Last updated
Nov 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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 SA0003586 FL Primary

Addresses

Primary practice location

315 NE 10TH Ave
Crystal River, FL 34429-4456

Mailing address

14 Drypetes CT W
Homosassa, FL 34446-4149
Phone (352) 382-3364

Other identifiers 3

IdentifierTypeStateIssuer
S2007OtherFLBLUE CROSS OF FL
882546700MedicaidFL
4900706OtherGHI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100929001582 FL Practitioner - Qualified Speech Language Pathologist 4587705934 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
SA0003586FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Superior Therapy Services Inc Speech-Language Pathologist Current Accepting new patients

Organizations & group practices 2

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": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1740278142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 DRYPETES CT W",
            "city": "HOMOSASSA",
            "state": "FL",
            "postal_code": "344464149",
            "telephone_number": "352-382-3364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 NE 10TH AVE",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344294456",
            "telephone_number": "352-795-7006",
            "fax_number": "352-795-7008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "DEBORAH",
        "middle_name": "REGISTRATO",
        "name_prefix": "Dr.",
        "credential": "PHD,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-10",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA0003586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF FL",
            "identifier": "S2007",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "882546700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "4900706",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal River, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.