Individual provider Active NPI

Cynthia Castle Weathers, CCC/SLP

  • Speech-Language Pathologist
  • Keller, TX
National Provider Identifier
1003574328
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
101299 Issued in TX
Practice address
350 Keller Pkwy
Keller, TX 76248-2249
Phone
(817) 744-2328
NPI assigned
Dec 3, 2021
Last updated
Dec 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 101299 TX Primary

Addresses

Primary practice location

350 Keller Pkwy
Keller, TX 76248-2249

Mailing address

350 Keller Pkwy
Keller, TX 76248-2249
Phone (817) 744-2328

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ccweathers@icloud.com Direct Keller ISD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241024002245 TX Practitioner - Qualified Speech Language Pathologist 1153854427 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
102199TXMDLodging Provider
101299TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Matt Bonander LLC CurrentSince Oct 1, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1003574328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 KELLER PKWY",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482249",
            "telephone_number": "817-744-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 KELLER PKWY",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482249",
            "telephone_number": "817-744-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERS",
        "first_name": "CYNTHIA",
        "middle_name": "CASTLE",
        "credential": "CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-03",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "101299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccweathers@icloud.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Keller ISD",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "350 Keller Pkwy",
            "city": "Keller",
            "state": "TX",
            "country_code": "US",
            "postal_code": "762482249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Keller, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.