Nicoll Medina Montero

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

License

40848 Issued in TX

Practice address

1351 E Bardin Rd Ste 160
Arlington, TX 76018-2136

Phone

(817) 795-1291

NPI assigned

Oct 3, 2018

Last updated

Oct 3, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Epic Pediatric Therapy, LP.

  dba Aveanna Healthcare

  • Rehabilitation Clinic/Center
  • Arlington, TX
  • NPI 1013163377
  NPD (past)

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1235614488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 NE LOOP 820; BUSINESS TOWER 1,",
            "address_2": "SUITE 200",
            "city": "HURST",
            "state": "TX",
            "postal_code": "76053",
            "telephone_number": "817-292-8787",
            "fax_number": "817-789-6849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 E BARDIN RD STE 160",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760182136",
            "telephone_number": "817-795-1291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA MONTERO",
        "first_name": "NICOLL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "TX",
            "license": "40848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medical Equipment Specialists
• Medical Services Exchange
• Medical Strategic Partners
• Medicine Ally PLLC
• Alma N Medina Delgado, MD
• Alexis Christian Medina
• Ravin Medina, LCSW
• Richard A Medina, RNFA
• Medque Family Health NP. PLLC (Medque Health Center)
• Medrik Medical Equipment &Supplies

• Speech-Language Assistant in Arlington, TX
• Providers in Arlington, TX by specialty
• Speech-Language Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.