Krystal Camacho

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

18509 Issued in FL

Practice address

130 Heights Ave
Inverness, FL 34452-4571

Phone

(352) 419-6570

NPI assigned

Sep 27, 2016

Last updated

Nov 10, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Exceptional Pediatric Therapy LLC

  • Speech-Language Pathologist
  • Houston, TX
  • NPI 1831440239
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1881143253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1849 JUSTICE CIR",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325639610",
            "telephone_number": "314-660-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 HEIGHTS AVE",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344524571",
            "telephone_number": "352-419-6570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9610 Long Point Rd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770554265",
            "country_code": "US",
            "telephone_number": "832-487-9872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "KRYSTAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-27",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "113069",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "18509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charmaine Mumtaz Butt, MD
• Buy It Now Antiques&Collectibles LLC (Outreach Senior Companion Services)
• C&K Nemt LLC
• Richrd Harold Cain Jr., RBT
• Andrew Calma
• Rebecca Faye Campbell, L.M.T.
• Stephen D Campbell, M.D.
• Laura Karina Camps Abbott, M.D.
• Boyd Theodore Cantrell III, M.P.T.
• Marion Maraguinot Capahi, M.D.

• Speech-Language Pathologist in Inverness, FL
• Providers in Inverness, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.