Individual provider Active NPI

Kristina Ann Newby, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Rock Springs, WY
National Provider Identifier
1053994608
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP-1102 Issued in WY
Practice address
479 Fairview LN
Rock Springs, WY 82901-2914
Phone
(307) 705-2878
NPI assigned
May 2, 2021
Last updated
Jun 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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 SP-1102 WY Primary

Addresses

Primary practice location

479 Fairview LN
Rock Springs, WY 82901-2914

Mailing address

479 Fairview LN
Rock Springs, WY 82901-2914
Phone (307) 705-2878

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240921000525 WY Practitioner - Qualified Speech Language Pathologist 5092256792 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SP-1102WYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sweetwater Speaks Speech Therapy PC Speech-Language Pathologist CurrentSince Jun 14, 2021 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1619913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1053994608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "479 FAIRVIEW LN",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829012914",
            "telephone_number": "307-705-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 FAIRVIEW LN",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829012914",
            "telephone_number": "307-705-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBY",
        "first_name": "KRISTINA",
        "middle_name": "ANN",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-02",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WY",
            "license": "SP-1102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Springs, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.

Verify at the official NPI Registry.