CELINA RAE FULLER (CCC-SLP) – Speech-Language Pathologist, NPI 1184902629

CELINA RAE FULLER (CCC-SLP) is a healthcare provider. based in Salisbury, Vermont. specializing in QUALIFIED SPEECH LANGUAGE PATHOLOGIST. They hold the professional credentials CCC-SLP. They hold a License No. 8045244 (VT). The NPI Number for CELINA RAE FULLER (CCC-SLP) is 1184902629

Main info

Female
Sole Proprietor
17 Years Of Experience
Accepts Medicare Assignment
Name
CELINA RAE FULLER (CCC-SLP)
NPI
1184902629
Phone
(802) 352-4727
Address
1974 W SHORE RD
Enumeration Date
2 August 2011
Last Update Date
2 August 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8028776991
Graduation Year
2009 (17 years ago)
PAC ID
9133618325
Group Practice PAC ID
4587983374
Professional Enrollment ID
I20251028004131
Address ID
VT054918905VE75XXXRDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

13 QUALIFIED SPEECH LANGUAGE PATHOLOGIST in VT

Provider Addresses for CELINA RAE FULLER (CCC-SLP)

  • 1974 W SHORE RD

    SALISBURY, VT 057699740

    Phone: (802) 352-4727

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-10-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251028004131IQualified Speech Language PathologistVTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 05769)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4587983374View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeVT
Physical Therapist In Private PracticeVT
Physical Therapist In Private PracticeMA

Reviews

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Frequently asked questions

Can I use this page to confirm CELINA RAE FULLER (CCC-SLP)'s NPI?
Yes. CELINA RAE FULLER (CCC-SLP) is listed with NPI 1184902629 in the public NPI dataset.
Is CELINA RAE FULLER (CCC-SLP) still practicing?
CELINA RAE FULLER (CCC-SLP) is currently listed as active in the public NPI registry.
What is CELINA RAE FULLER (CCC-SLP)'s specialty?
The listing groups CELINA RAE FULLER (CCC-SLP) with Speech-Language Pathologist. Clinical services aligned with this taxonomy classification.
Does CELINA RAE FULLER (CCC-SLP) list a practice location?
Patients near Salisbury, Vermont may find CELINA RAE FULLER (CCC-SLP) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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