NPIMap

Organization Active NPI

Washington State University

  • Speech-Language Pathologist
  • Pullman, WA
National Provider Identifier
1962559054
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
00549253 Issued in WA
Legal business name
WASHINGTON STATE UNIVERSITY
Practice address
Daggy Hall, Room 133
Pullman, WA 99164-2420
Phone
(509) 335-1509
Fax
(509) 335-8357
NPI assigned
Jan 4, 2007
Last updated
Jul 15, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
WASHINGTON STATE UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

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

Authorized official

Name
Dr. Gail D. Chermak, PH.D., CCC-A
Title
Professor and Chair
Phone
(509) 335-4526

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assistive Technology Supplier Audiologist 231HA2500X 00003762 WA
Speech-Language Pathologist 235Z00000X 00549253 WA Primary

Addresses

Primary practice location

Daggy Hall, Room 133
Pullman, WA 99164-2420

Mailing address

Daggy Hall, Room 133
Pullman, WA 99164-2420
Phone (509) 335-1509

Other identifiers 8

IdentifierTypeStateIssuer
17209OtherWASPEECHLANGUAGEHEARING
224297224297OtherWASPEECHLANGUAGEHEARING
805173000MedicaidID
000010156099OtherIDSPEECHLANGUAGEHEARING
000010156099OtherWASPEECHLANGUAGEHEARING
7118771MedicaidWA
75243OtherWASPEECHLANGUAGEHEARING
7259302MedicaidWA

Other names 1

  • Speech and Hearing Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040727000292 WA Part B Supplier - Clinic/Group Practice 2567432743 Receives reassigned benefits from 3 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pullman, WA; Spokane, WA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Washington State University

Locations

133 Daggy Hall
Pullman, WA 99164
Phone (509) 335-1509

Daggy Hall
Rm 133
Pullman, WA 99164
Phone (509) 335-1509

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216080000000",
    "number": "1962559054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DAGGY HALL, ROOM 133",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991642420",
            "telephone_number": "509-335-1509",
            "fax_number": "509-335-8357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DAGGY HALL, ROOM 133",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991642420",
            "telephone_number": "509-335-1509",
            "fax_number": "509-335-8357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON STATE UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WASHINGTON STATE UNIVERSITY",
        "enumeration_date": "2007-01-04",
        "last_updated": "2008-07-15",
        "status": "A",
        "authorized_official_last_name": "CHERMAK",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PROFESSOR AND CHAIR",
        "authorized_official_telephone_number": "509-335-4526",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., CCC-A"
    },
    "taxonomies": [
        {
            "code": "231HA2500X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Supplier",
            "state": "WA",
            "license": "00003762",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "00549253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECHLANGUAGEHEARING",
            "identifier": "17209",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECHLANGUAGEHEARING",
            "identifier": "224297224297",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805173000",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECHLANGUAGEHEARING",
            "identifier": "000010156099",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECHLANGUAGEHEARING",
            "identifier": "000010156099",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7118771",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECHLANGUAGEHEARING",
            "identifier": "75243",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7259302",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Speech and Hearing Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pullman, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; 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.