Active NPI
Alicia N Richmond, CCC
- Speech-Language Pathologist
- Burleson, TX
National Provider Identifier
1255071668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 16124
- Practice address
- 1160 SW Wilshire Blvd
Burleson, TX 76028-5719 - Phone
- (817) 245-1000
- NPI assigned
- Apr 1, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 16124 | TX | Primary |
Addresses
Primary practice location
1160 SW Wilshire Blvd
Burleson, TX 76028-5719
Mailing address
4205 Lanark Ave
Fort Worth, TX 76109-5333
Phone (817) 926-7733
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16124 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648771200000",
"number": "1255071668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4205 LANARK AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761095333",
"telephone_number": "817-926-7733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1160 SW WILSHIRE BLVD",
"city": "BURLESON",
"state": "TX",
"postal_code": "760285719",
"telephone_number": "817-245-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHMOND",
"first_name": "ALICIA",
"middle_name": "N",
"credential": "CCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-01",
"last_updated": "2022-04-01",
"certification_date": "2022-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "16124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burleson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.