Nickole A Hines-Staples, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

103963 Issued in TX

Practice address

1601 Trinity St
Austin, TX 78712-1765

Phone

(512) 495-5257

Fax

(989) 774-1891

NPI assigned

Feb 26, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516838400000",
    "number": "1225207996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 ROADRUNNER DR",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786135105",
            "telephone_number": "713-203-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 TRINITY ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787121765",
            "telephone_number": "512-495-5257",
            "fax_number": "989-774-1891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINES-STAPLES",
        "first_name": "NICKOLE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-26",
        "last_updated": "2018-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101004319",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "103963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS LICENSE",
            "identifier": "103963",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA",
            "identifier": "12111764",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN LICENSE",
            "identifier": "7101004319",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chellyanne Hinds, PA-C
• Kathy Dianne Hinds, LMT,RDH
• Jennifer N Hine, LCDC
• Louis K Hine, MD
• Peter W Hine, M.D.
• Justiss Amani Hines
• Lorissa Hines, MD
• Terrance S Hines, MD
• Timothy Reed Hines, MD
• Lauren Louise Hinkel, LMSW, MPH

• Speech-Language Pathologist in Austin, TX
• Providers in Austin, 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 Jan 25, 2018; 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.