Active NPI
Jessica Russell
- Speech-Language Pathologist
- Hillsboro, TX
National Provider Identifier
1053049940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 119705
- Practice address
- 200 Line St
Hillsboro, TX 76645-3149 - Phone
- (254) 582-3814
- NPI assigned
- Aug 10, 2022
- Last updated
- Aug 10, 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 | 119705 | TX | Primary |
Addresses
Primary practice location
200 Line St
Hillsboro, TX 76645-3149
Mailing address
212 S 3Rd St
Abbott, TX 76621-3031
Phone (254) 205-9696
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 |
|---|---|---|---|
| 119705 | TX | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660089600000",
"number": "1053049940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "212 S 3RD ST",
"city": "ABBOTT",
"state": "TX",
"postal_code": "766213031",
"telephone_number": "254-205-9696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 LINE ST",
"city": "HILLSBORO",
"state": "TX",
"postal_code": "766453149",
"telephone_number": "254-582-3814"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-10",
"last_updated": "2022-08-10",
"certification_date": "2022-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "119705",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hillsboro, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.