Katie Broom, M.A. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

114445 Issued in TX

Practice address

107 S Judy St
Hallettsville, TX 77964-3223

Phone

(361) 210-7366

Fax

(361) 799-5001

NPI assigned

May 21, 2018

Sex

Female

Sole proprietor

Yes

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.

• Texas Elite Therapy Team LLC

  • Speech-Language Pathologist
  • Hallettsville, TX
  • NPI 1356038947
  Medicare reassignment Care Compare group NPD Authorized official
• Endeavor Rehab Center Inc

  • Physical Therapist
  • Fort Worth, TX
  • NPI 1104956648
  NPD (past)

Specialty

Qualified Speech Language Pathologist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Elite Therapy Team LLC 2 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in TX

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 13, 2024.

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1003307547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 166",
            "city": "HALLETTSVILLE",
            "state": "TX",
            "postal_code": "779640166",
            "telephone_number": "361-210-7366",
            "fax_number": "361-799-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S JUDY ST",
            "city": "HALLETTSVILLE",
            "state": "TX",
            "postal_code": "779643223",
            "telephone_number": "361-210-7366",
            "fax_number": "361-799-5001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 E Airline Rd",
            "address_purpose": "LOCATION",
            "city": "Victoria",
            "state": "TX",
            "postal_code": "779014000",
            "country_code": "US",
            "telephone_number": "361-210-7366",
            "fax_number": "361-799-5001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "711 N Avenue D",
            "address_purpose": "LOCATION",
            "city": "Shiner",
            "state": "TX",
            "postal_code": "779845210",
            "country_code": "US",
            "telephone_number": "361-210-7366",
            "fax_number": "361-799-5001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 Shult Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "TX",
            "postal_code": "789343009",
            "country_code": "US",
            "telephone_number": "361-210-7366",
            "fax_number": "361-799-5001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOM",
        "first_name": "KATIE",
        "name_prefix": "Mrs.",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-21",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "114445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allmed Sales & Rentals, Inc
• Sarah Ballard, FNP-C
• Adam Ewell Batson, PTA
• Jackson T. Biggs, M.D.
• Brookshire Brothers Inc
• Duane Bushman, PTA
• Haylie Cernoch, M.S. CCC- SLP
• Kelly Deann Chance, MPT
• Jack Cherry
• Citizens Medical Center County of Victoria

• All providers in Hallettsville, TX
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.