Active NPI
Taylor Campbell
- Speech-Language Assistant
- Lake Havasu City, AZ
National Provider Identifier
1760926786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SLPA10212
- Practice address
- 1515 Lake Havasu Ave N
Lake Havasu City, AZ 86404-1177 - Phone
- (928) 854-5439
- Fax
- (928) 854-5440
- NPI assigned
- Dec 9, 2016
- Sex
- Female
- 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 Assistant | 2355S0801X | SLPA10212 | AZ | Primary |
Addresses
Primary practice location
1515 Lake Havasu Ave N
Lake Havasu City, AZ 86404-1177
Mailing address
3538 Heather Ave
Kingman, AZ 86401-3820
Phone (928) 854-5439
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 819797 | Medicaid | AZ |
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 |
|---|---|---|---|
| SLPA10212 | AZ | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Milemarkers Therapy | Speech-Language Pathologist | Past | Accepting new patients |
| Milemarkers Therapy | Past | 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 and National Provider Directory roles.
-
- Speech-Language Pathologist
- Lake Havasu City, AZ
- NPI 1215487376
-
- Occupational Therapist
- Lake Havasu City, AZ
- NPI 1336594951
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481241600000",
"number": "1760926786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3538 HEATHER AVE",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "864013820",
"telephone_number": "928-854-5439",
"fax_number": "928-854-5440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 LAKE HAVASU AVE N",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "864041177",
"telephone_number": "928-854-5439",
"fax_number": "928-854-5440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "TAYLOR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-09",
"last_updated": "2016-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "AZ",
"license": "SLPA10212",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "819797",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Havasu City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.