Active NPI
Kristin D Breshears, SLP
- Speech-Language Pathologist
- Austin, TX
National Provider Identifier
1083712194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 18572
- Practice address
- 5524 Bee Cave Rd
BLDG M
Austin, TX 78716-2904 - Phone
- (512) 306-1707
- Fax
- (512) 306-7380
- NPI assigned
- Sep 20, 2006
- Last updated
- Jul 8, 2007
- 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 | 18572 | TX | Primary |
Addresses
Primary practice location
5524 Bee Cave Rd
BLDG M
Austin, TX 78716-2904
Mailing address
PO Box 162904
Austin, TX 78716-2904
Phone (512) 306-1707
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8T4325 | Other | TX | BCBS |
| 18572 | Other | TX | STATE BOARD |
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 |
|---|---|---|---|
| 18572 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Giraffe Inc | Speech-Language Pathologist | Past | 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.
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- NPI 1841321312
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083712194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 162904",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787162904",
"telephone_number": "512-306-1707",
"fax_number": "512-306-7380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5524 BEE CAVE RD",
"address_2": "BLDG M",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787162904",
"telephone_number": "512-306-1707",
"fax_number": "512-306-7380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRESHEARS",
"first_name": "KRISTIN",
"middle_name": "D",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "18572",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8T4325",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE BOARD",
"identifier": "18572",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.