Individual provider Active NPI

Kathryn Brakemeier, MS, CCC-SLP

  • Speech-Language Pathologist
  • Fort Worth, TX
National Provider Identifier
1013433689
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
100296 Issued in TX
Practice address
3628 Horace Ave
Fort Worth, TX 76244-8664
Phone
(817) 706-9566
NPI assigned
Aug 16, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 100296 TX Primary

Addresses

Primary practice location

3628 Horace Ave
Fort Worth, TX 76244-8664

Mailing address

3628 Horace Ave
Fort Worth, TX 76244-8664
Phone (817) 706-9566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
100296TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kathryn Brakemeier CurrentSince Jul 24, 2022 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1013433689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3628 HORACE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448664",
            "telephone_number": "817-706-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3628 HORACE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448664",
            "telephone_number": "817-706-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAKEMEIER",
        "first_name": "KATHRYN",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "100296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.