Active NPI
Darla R Fountain, SLP
- Speech-Language Pathologist
- Kaufman, TX
National Provider Identifier
1326084864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 14573
- Practice address
- 1409 Overlook Dr
Kaufman, TX 75142-3818 - Phone
- (903) 826-7380
- Fax
- (214) 889-9580
- NPI assigned
- Jun 22, 2006
- Last updated
- Feb 11, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 | 14573 | TX | Primary |
Addresses
Primary practice location
1409 Overlook Dr
Kaufman, TX 75142-3818
Mailing address
1409 Overlook Dr
Kaufman, TX 75142-3818
Phone (903) 826-7380
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 089225901 | Medicaid | TX | |
| 118613721 | Medicaid | AR | |
| 528367 | Other | TX | BLUE CROSS |
| 97971 | Other | AR | BLUE CROSS |
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 |
|---|---|---|---|
| 14573 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Speech Pathology Services PLLC | Speech-Language Pathologist | Current | Accepting new patients |
| Speech Pathology Services | Speech-Language Pathologist | Past | Accepting new patients |
Locations
2208 College Dr
Texarkana, TX 75503
Phone (903) 792-3986
4824 McKnight Rd
Texarkana, TX 75503
Phone (903) 614-5800
Organizations & group practices 2
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.
-
- Speech-Language Pathologist
- Kaufman, TX
- NPI 1467630442
-
- Speech-Language Pathologist
- Texarkana, TX
- NPI 1780785493
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739232000000",
"number": "1326084864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1409 OVERLOOK DR",
"city": "KAUFMAN",
"state": "TX",
"postal_code": "751423818",
"telephone_number": "903-826-7380",
"fax_number": "214-889-9580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1409 OVERLOOK DR",
"city": "KAUFMAN",
"state": "TX",
"postal_code": "751423818",
"telephone_number": "903-826-7380",
"fax_number": "214-889-9580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOUNTAIN",
"first_name": "DARLA",
"middle_name": "R",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-22",
"last_updated": "2025-02-11",
"certification_date": "2025-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "14573",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "089225901",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "118613721",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "528367",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "97971",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kaufman, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.