NPIMap

Organization Active NPI

Round Rock Children'S Therapy Center

  • Speech-Language Pathologist
  • Round Rock, TX
National Provider Identifier
1346595394
Registry record updated Jul 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
103115 Issued in TX
Legal business name
ROUND ROCK CHILDREN'S THERAPY CENTER
Practice address
33 Woodland LN
Round Rock, TX 78664-9774
Phone
(512) 797-3187
NPI assigned
Jul 16, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2012

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

Authorized official

Name
Melissa Balthazor, CCC-SLPNPI 1821112269
Title
Speech Language Pathologist
Phone
(512) 797-3187

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 103115 TX Primary

Addresses

Primary practice location

33 Woodland LN
Round Rock, TX 78664-9774

Mailing address

33 Woodland LN
Round Rock, TX 78664-9774

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220930001638 TX Part B Supplier - Clinic/Group Practice 9436535291 Receives reassigned benefits from 1 practitioner
Practice locations: Round Rock, TX

National Provider Directory

National Provider Directory
Tax ID family
Round Rock Children'S Therapy Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12 Chisholm Trail Rd
Ste 100
Round Rock, TX 78681
Phone (512) 341-9991

503 E Palm Valley Blvd
Ste 300
Round Rock, TX 78664
Phone (512) 341-9991

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342396800000",
    "number": "1346595394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 WOODLAND LN",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786649774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 WOODLAND LN",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786649774",
            "telephone_number": "512-797-3187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROUND ROCK CHILDREN'S THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-16",
        "last_updated": "2012-07-16",
        "status": "A",
        "authorized_official_last_name": "BALTHAZOR",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "512-797-3187",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "103115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; 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.