Active NPI
Kyndal Nicole Crowder, SLP
- Speech-Language Pathologist
- Clifton, TX
National Provider Identifier
1053026864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 100 N Avenue G Ste B
Clifton, TX 76634-1524 - Phone
- (817) 223-0625
- NPI assigned
- Jan 16, 2023
- Last updated
- Nov 22, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
100 N Avenue G Ste B
Clifton, TX 76634-1524
Mailing address
100 N Avenue G Ste B
Clifton, TX 76634-1524
Phone (817) 223-0625
Other names 1
- Kyndal Nicole Crowder
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250313004096 | TX | Practitioner - Qualified Speech Language Pathologist | 1254853732 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120585 | TX | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732233600000",
"number": "1053026864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N AVENUE G STE B",
"city": "CLIFTON",
"state": "TX",
"postal_code": "766341524",
"telephone_number": "817-223-0625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N AVENUE G STE B",
"city": "CLIFTON",
"state": "TX",
"postal_code": "766341524",
"telephone_number": "817-223-0625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROWDER",
"first_name": "KYNDAL",
"middle_name": "NICOLE",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-16",
"last_updated": "2024-11-22",
"certification_date": "2024-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KYNDAL",
"last_name": "CROWDER",
"middle_name": "NICOLE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Clifton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.