Individual provider Active NPI

Emma Wermuth, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Austin, TX
National Provider Identifier
1114336476
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1104403 Issued in TX
Practice address
4131 Spicewood Springs Rd Ste K2
Austin, TX 78759-8600
Phone
(512) 200-2792
Fax
(877) 331-1021
NPI assigned
Aug 11, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 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 1104403 TX Primary

Addresses

Primary practice location

4131 Spicewood Springs Rd Ste K2
Austin, TX 78759-8600

Mailing address

4131 Spicewood Springs Rd Ste K2
Austin, TX 78759-8600
Phone (512) 200-2792

Other practice location 1

125 Rose St Ste 201
Buda, TX 78610-4222
Phone (512) 200-2792

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1104403TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Behavior Therapy Speech-Language Pathologist CurrentSince Nov 10, 2024 Accepting new patients

Locations

4131 Spicewood Springs Rd
Ste K2
Austin, TX 78759
Phone (512) 200-2792

125 Rose St
Ste 201
Buda, TX 78610
Phone (512) 200-2792

119 Cimarron Park Loop
Ste A
Buda, TX 78610
Phone (512) 200-2792

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": "1407715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1114336476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 SPICEWOOD SPRINGS RD STE K2",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598600",
            "telephone_number": "512-200-2792",
            "fax_number": "877-331-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 SPICEWOOD SPRINGS RD STE K2",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598600",
            "telephone_number": "512-200-2792",
            "fax_number": "877-331-1021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Rose St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Buda",
            "state": "TX",
            "postal_code": "786104222",
            "country_code": "US",
            "telephone_number": "512-200-2792",
            "fax_number": "877-331-1021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WERMUTH",
        "first_name": "EMMA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-11",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "1104403",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.