Active NPI
Michelle Kruebbe, CCC/SLP
- Speech-Language Pathologist
- Joaquin, TX
National Provider Identifier
1023735990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 100412
- Practice address
- 11109 US Highway 84 E
Joaquin, TX 75954-2479 - Phone
- (936) 269-3128
- Fax
- (936) 269-9433
- NPI assigned
- Oct 21, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 100412 | TX | Primary |
Addresses
Primary practice location
11109 US Highway 84 E
Joaquin, TX 75954-2479
Mailing address
107 Meadowbrook St
Carthage, TX 75633-2240
Phone (903) 220-9563
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
| License | State | Type | Specialty |
|---|---|---|---|
| 100412 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Joaquin Independent School District | Past | 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.
-
- Local Education Agency (LEA)
- Joaquin, TX
- NPI 1922563840
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666310400000",
"number": "1023735990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 MEADOWBROOK ST",
"city": "CARTHAGE",
"state": "TX",
"postal_code": "756332240",
"telephone_number": "903-220-9563"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11109 US HIGHWAY 84 E",
"city": "JOAQUIN",
"state": "TX",
"postal_code": "759542479",
"telephone_number": "936-269-3128",
"fax_number": "936-269-9433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUEBBE",
"first_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "CCC/SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-21",
"last_updated": "2022-10-21",
"certification_date": "2022-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "100412",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joaquin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 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.