Active NPI
Rebecca Ann St.Amant
- Speech-Language Pathologist
- Fort Worth, TX
National Provider Identifier
1043940943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 109235
- Practice address
- 3524 N Crump St
Fort Worth, TX 76106-4420 - Phone
- (817) 815-0500
- NPI assigned
- Jun 14, 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 | 109235 | TX | Primary |
Addresses
Primary practice location
3524 N Crump St
Fort Worth, TX 76106-4420
Mailing address
5221 Agave Way
Fort Worth, TX 76126-3040
Phone (817) 905-9397
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 659249401 | Medicaid | TX |
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 |
|---|---|---|---|
| 109235 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655164800000",
"number": "1043940943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5221 AGAVE WAY",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761263040",
"telephone_number": "817-905-9397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3524 N CRUMP ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761064420",
"telephone_number": "817-815-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ST.AMANT",
"first_name": "REBECCA",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-14",
"last_updated": "2022-06-14",
"certification_date": "2022-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "109235",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "659249401",
"state": "TX"
}
],
"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 Jun 14, 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.