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Deactivated NPI 1689879272 Deactivated / Inactive NPI Female Practitioner

Carol Pettigrew , MS, CCC-SLP

Speech-Language Pathologist • Boulder, CO

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Carol Pettigrew has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 15, 2007
NPI Deactivation Date December 07, 2018
Total Practice Duration ~11 Years of Practice (2007 – 2018)

Professional Overview & Biography Verified Profile Summary

Carol Pettigrew, MS, CCC-SLP was a registered Speech-Language Pathologist practicing in Boulder, CO. Throughout an active medical career spanning 11 years, Carol Pettigrew provided care at the practice location at 2121 MESA DR until profile deactivation on 2018-12-07.

Practice Location & Contact Primary Location

Practice Address

2121 Mesa Dr

Boulder, CO 803043621

Telephone 7205652693
Associated Practice Facility / Clinic
🏢 Buckeye M, Llc Facility NPI 1689665119

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Boulder, CO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 23.3 Yrs
State Avg: 10.8 Yrs
Regional Practice Density
167 Specialists

Practicing in Boulder, CO (4289 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License FL SA12033

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Rosemary Hegarty , PT

Physical Therapist

NPI 1053515676

Physical Therapist

Matthew Shea , PT

Physical Therapist

NPI 1124223524

Physical Therapist

Richard Chubbs , PTA

Physical Therapy Assistant

NPI 1295939841

Physical Therapist Assistant

Afsaneh Harris

Physical Therapist

NPI 1386838985
Carol Myers , OT

Occupational Therapist

NPI 1598960163

Occupational Therapist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated December 07, 2018

Record deactivated on December 07, 2018

NPI Profile Active February 25, 2014

NPI status registered as active in NPPES database

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Updated Practice Location February 25, 2014

Registered at 2121 MESA DR, BOULDER, CO 803043621 (Tel: 7205652693)

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Updated Business Mailing Address February 25, 2014

Registered at 4396 SW BIMINI CIR S, PALM CITY, FL 349901347 (Tel: 3038835986)

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Provider Name / Credentials Updated February 25, 2014

Recorded as CAROL PETTIGREW, M.S., CCC-SLP

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 25, 2014

Speech-Language Pathologist (License #SA12033 in FL)

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Initial NPI Registration & Enumeration June 15, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1689879272
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 15, 2007
Last Update: February 25, 2014
Deactivation Date: December 07, 2018

Mailing Address

4396 Sw Bimini Cir S

Palm City, FL 349901347

Phone: 3038835986

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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