Individual provider Active NPI

Danielle Chatham

  • Speech-Language Pathologist
  • Fort Worth, TX
National Provider Identifier
1043736150
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
115030 Issued in TX
Practice address
2701 Airport Fwy Ste a
Fort Worth, TX 76111
Phone
(682) 564-5476
NPI assigned
Aug 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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 115030 TX Primary

Addresses

Primary practice location

2701 Airport Fwy Ste a
Fort Worth, TX 76111

Mailing address

2701 Airport Fwy Ste a
Fort Worth, TX 76111-2378

Other practice location 1

1500 S Ave K
Station 3, SHROC
Portales, NM 88130
Phone (575) 562-2156

Other practice location 2

1500 S Ave K
Station 3, SHROC
Portales, NM 88130
Phone (575) 562-2156

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
115030TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern New Mexico University Speech-Language Pathologist PastSince Nov 12, 2023 Accepting new patients
Kenneth Ray Ruelas Jr Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 2

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": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1043736150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 AIRPORT FWY STE A",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761112378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 AIRPORT FWY STE A",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76111",
            "telephone_number": "682-564-5476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Ave K",
            "address_2": "Station 3, SHROC",
            "address_purpose": "LOCATION",
            "city": "Portales",
            "state": "NM",
            "postal_code": "88130",
            "country_code": "US",
            "telephone_number": "575-562-2156",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 S Ave K",
            "address_2": "Station 3, SHROC",
            "address_purpose": "LOCATION",
            "city": "Portales",
            "state": "NM",
            "postal_code": "88130",
            "country_code": "US",
            "telephone_number": "575-562-2156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHATHAM",
        "first_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-21",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "115030",
            "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 Sep 20, 2018; 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.