Individual provider Active NPI

Sharee Nicole Cupp, SLP ASSISTANT

  • Speech-Language Assistant
  • Fort Worth, TX
National Provider Identifier
1316571003
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
36165 Issued in TX
Practice address
6530 Hawks Creek CT Ste 107
Fort Worth, TX 76114-1164
Phone
(817) 435-4631
NPI assigned
Mar 3, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 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 Assistant 2355S0801X 36165 TX Primary

Addresses

Primary practice location

6530 Hawks Creek CT Ste 107
Fort Worth, TX 76114-1164

Mailing address

4351 FM 1195
Mineral Wells, TX 76067-0731
Phone (940) 745-0286

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
36165TXMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1316571003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4351 FM 1195",
            "city": "MINERAL WELLS",
            "state": "TX",
            "postal_code": "760670731",
            "telephone_number": "940-745-0286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6530 HAWKS CREEK CT STE 107",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761141164",
            "telephone_number": "817-435-4631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUPP",
        "first_name": "SHAREE",
        "middle_name": "NICOLE",
        "credential": "SLP ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-03",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "TX",
            "license": "36165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.