Individual provider Active NPI

Melissa Carol Stockholm

  • Speech-Language Pathologist
  • Denton, TX
National Provider Identifier
1245851997
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
17748 Issued in TX
Practice address
3824 Chimney Rock Dr
Denton, TX 76210-3398
Phone
(940) 703-2657
NPI assigned
May 5, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 17748 TX Primary

Addresses

Primary practice location

3824 Chimney Rock Dr
Denton, TX 76210-3398

Mailing address

3824 Chimney Rock Dr
Denton, TX 76210-3398
Phone (940) 703-2657

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
17748TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1245851997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3824 CHIMNEY ROCK DR",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762103398",
            "telephone_number": "940-703-2657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3824 CHIMNEY ROCK DR",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762103398",
            "telephone_number": "940-703-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKHOLM",
        "first_name": "MELISSA",
        "middle_name": "CAROL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-05",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "17748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; 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.