Individual provider Active NPI

Rebecca Stewart, MSLP

  • Speech-Language Pathologist
  • Grand Saline, TX
National Provider Identifier
1194896696
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
100393 Issued in TX
Practice address
102 E Grand PLZ
Grand Saline, TX 75140-1932
Phone
(903) 962-7901
Fax
(903) 962-3082
NPI assigned
Nov 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 100393 TX Primary

Addresses

Primary practice location

102 E Grand PLZ
Grand Saline, TX 75140-1932

Mailing address

709 Fair Laine
Tyler, TX 75701
Phone (903) 962-7901

Other identifiers 1

IdentifierTypeStateIssuer
8T5123OtherTXBCBS PAR

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

LicenseStateTypeSpecialty
100393TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ellis Rehabilitation Services, Inc. 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.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194896696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 FAIR LAINE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-962-7901",
            "fax_number": "903-962-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E GRAND PLZ",
            "city": "GRAND SALINE",
            "state": "TX",
            "postal_code": "751401932",
            "telephone_number": "903-962-7901",
            "fax_number": "903-962-3082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "REBECCA",
        "credential": "MSLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "100393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PAR",
            "identifier": "8T5123",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Saline, 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.

Verify at the official NPI Registry.