Individual provider Active NPI

Cristin Linebach, SLP

  • Speech-Language Pathologist
  • Suffolk, VA
National Provider Identifier
1295068039
Registry record updated Sep 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202005813 Issued in VA
Practice address
2007 Meade Pkwy
Suffolk, VA 23434-4259
Phone
(757) 539-6300
Fax
(757) 539-0704
NPI assigned
Sep 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2202005813 VA Primary

Addresses

Primary practice location

2007 Meade Pkwy
Suffolk, VA 23434-4259

Mailing address

2007 Meade Pkwy
Suffolk, VA 23434-4259
Phone (757) 539-6300

Other identifiers 1

IdentifierTypeStateIssuer
004979796MedicaidVA

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
2202005813VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1252627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252627200000",
    "number": "1295068039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 MEADE PKWY",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344259",
            "telephone_number": "757-539-6300",
            "fax_number": "757-539-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 MEADE PKWY",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344259",
            "telephone_number": "757-539-6300",
            "fax_number": "757-539-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINEBACH",
        "first_name": "CRISTIN",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-11",
        "last_updated": "2009-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202005813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004979796",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2009; 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.