Individual provider Active NPI

Kendra Gruben, CCC-SLP

  • Speech-Language Pathologist
  • Brownwood, TX
National Provider Identifier
1013653559
Registry record updated May 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
10892 Issued in TX
Practice address
800 Rogan St
Brownwood, TX 76801-3339
Phone
(325) 646-8919
NPI assigned
May 9, 2022
Last updated
May 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 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 10892 TX Primary

Addresses

Primary practice location

800 Rogan St
Brownwood, TX 76801-3339

Mailing address

800 Rogan St
Brownwood, TX 76801-3339
Phone (325) 646-8919

Other practice location 1

2700 Vincent St
Brownwood, TX 76801-5845
Phone (325) 646-2937

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

State licenses

LicenseStateTypeSpecialty
10892TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1652054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1013653559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ROGAN ST",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "768013339",
            "telephone_number": "325-646-8919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROGAN ST",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "768013339",
            "telephone_number": "325-646-8919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Vincent St",
            "address_purpose": "LOCATION",
            "city": "Brownwood",
            "state": "TX",
            "postal_code": "768015845",
            "country_code": "US",
            "telephone_number": "325-646-2937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRUBEN",
        "first_name": "KENDRA",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-09",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "10892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownwood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.