Individual provider Active NPI

Kacie Daun Crowson, CCC-SLP

  • Speech-Language Pathologist
  • Sulphur Springs, TX
National Provider Identifier
1053858324
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
104374 Issued in TX
Practice address
110 Main St
Sulphur Springs, TX 75482-2705
Phone
(903) 243-0702
NPI assigned
Jan 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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 104374 TX Primary

Addresses

Primary practice location

110 Main St
Sulphur Springs, TX 75482-2705

Mailing address

130 Briarwood Cir
Sulphur Springs, TX 75482-7532
Phone (903) 243-0702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170601002571 TX Practitioner - Qualified Speech Language Pathologist 4587931134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

520 Davis St S
Sulphur Springs, TX 75482-4021
Phone (903) 243-0702

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104374TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bubble Speech Therapy Speech-Language Pathologist CurrentSince Mar 2, 2023 Accepting new patients

Locations

520 Davis St S
Sulphur Springs, TX 75482
Phone (903) 243-0702

110 Main St
Sulphur Springs, TX 75482
Phone (903) 243-0702

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1053858324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 BRIARWOOD CIR",
            "city": "SULPHUR SPRINGS",
            "state": "TX",
            "postal_code": "754827532",
            "telephone_number": "903-243-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MAIN ST",
            "city": "SULPHUR SPRINGS",
            "state": "TX",
            "postal_code": "754822705",
            "telephone_number": "903-243-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWSON",
        "first_name": "KACIE",
        "middle_name": "DAUN",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "104374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sulphur Springs, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.