Individual provider Active NPI

Rosa Michelle Berglund, SLPA

  • Speech-Language Assistant
  • Livingston, TX
National Provider Identifier
1275309767
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
42606 Issued in TX
Practice address
440 Highway 59 Loop S Ste 104
Livingston, TX 77351-9011
Phone
(936) 328-8148
Fax
(936) 327-2491
NPI assigned
Nov 27, 2023
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 42606 TX Primary

Addresses

Primary practice location

440 Highway 59 Loop S Ste 104
Livingston, TX 77351-9011

Mailing address

10518 Copper Ridge Dr
Cleveland, TX 77328-1867
Phone (309) 319-8135

Other names 1

  • Rosa Michelle Salas Former name

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
42606TXMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Rehabilitation,LLC Speech-Language Assistant PastSince Dec 3, 2023 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": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1275309767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10518 COPPER RIDGE DR",
            "city": "CLEVELAND",
            "state": "TX",
            "postal_code": "773281867",
            "telephone_number": "309-319-8135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 HIGHWAY 59 LOOP S STE 104",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773519011",
            "telephone_number": "936-328-8148",
            "fax_number": "936-327-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGLUND",
        "first_name": "ROSA",
        "middle_name": "MICHELLE",
        "credential": "SLPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "TX",
            "license": "42606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSA",
            "last_name": "SALAS",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Livingston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.