Nicole Schmoll Russwurm, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

118749 Issued in TX

Practice address

3301 TLC Way
San Angelo, TX 76901-2773

Phone

(325) 653-3200

NPI assigned

Sep 14, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Nicole Denice Schmoll Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1663113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1174245328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 TLC WAY",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769012773",
            "telephone_number": "325-653-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 TLC WAY",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769012773",
            "telephone_number": "325-653-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSWURM",
        "first_name": "NICOLE",
        "middle_name": "SCHMOLL",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-14",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "118749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicole.russwurm@texasleadership.net",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3301 Tlc Way",
            "city": "San Angelo",
            "state": "TX",
            "country_code": "US",
            "postal_code": "769012773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "SCHMOLL",
            "middle_name": "DENICE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maddelyn Rudd, LPCA
• Charles E Rudolph, PHD
• Ryan Rule, MD
• Ingrid Angela Russo, MSW, LCSW
• Harvey D Russwurm, MD
• Amy Rutherford, M. ED., LPC
• Mallory Rochelle Ryalls
• Kellie Marie Ryan - Wilson, CNM
• Ryan L Montgomery DDS MD PLLC
• Vernon L Ryan, MD

• Speech-Language Pathologist in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Speech-Language Pathologist in Texas

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

Verify at the official NPI Registry.