Individual provider Active NPI

Rebecca Butler, MCD CCC-SLP

  • Speech-Language Pathologist
  • Shreveport, LA
National Provider Identifier
1295298388
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8138 Issued in LA
Practice address
1450 Claiborne Ave
Shreveport, LA 71103-4204
Phone
(318) 813-2970
NPI assigned
Apr 7, 2019
Last updated
Jan 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 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 Pathologist 235Z00000X 8138 LA Primary

Addresses

Primary practice location

1450 Claiborne Ave
Shreveport, LA 71103-4204

Mailing address

9533 Rochel Dr
Shreveport, LA 71115-3854
Phone (318) 840-5876

Other practice location 1

9533 Rochel Dr
Shreveport, LA 71115-3854
Phone (318) 840-5876

Other names 1

  • Rebecca Durr Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200302001027 LA Practitioner - Qualified Speech Language Pathologist 9931536091 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8138LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice CurrentSince Feb 1, 2020 Accepting new patients
Lsuhsc-S School of Allied Health Speech-Language Pathologist CurrentSince Dec 1, 2022 Accepting new patients
Speech Bubble PastSince Jan 17, 2021 Accepting new patients

Locations

1450 Claiborne Ave
Shreveport, LA 71103
Phone (318) 813-2970

1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

Organizations & group practices 4

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": "1554595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1295298388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9533 ROCHEL DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711153854",
            "telephone_number": "318-840-5876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 CLAIBORNE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034204",
            "telephone_number": "318-813-2970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9533 Rochel Dr",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711153854",
            "country_code": "US",
            "telephone_number": "318-840-5876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "REBECCA",
        "credential": "MCD CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-07",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "8138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "DURR",
            "credential": "MCD CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.