Individual provider Active NPI

Tina Dipprey, SLP

  • Speech-Language Pathologist
  • Stephenville, TX
National Provider Identifier
1366739260
Registry record updated Apr 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
101000 Issued in TX
Practice address
515 W Lingleville Rd
Stephenville, TX 76401-2211
Phone
(254) 965-3611
NPI assigned
Jun 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2013

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 101000 TX Primary

Addresses

Primary practice location

515 W Lingleville Rd
Stephenville, TX 76401-2211

Mailing address

515 W Lingleville Rd
Stephenville, TX 76401-2211
Phone (254) 965-3611

Other identifiers 2

IdentifierTypeStateIssuer
81S921OtherTXBLUE CROSS BLUE SHIELD
295834001MedicaidTX

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
101000TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Countryside Therapy Group Home Health, LLC Past Accepting new patients
Countryside Therapy Group, Inc Speech-Language Pathologist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1366739260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W LINGLEVILLE RD",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764012211",
            "telephone_number": "254-965-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W LINGLEVILLE RD",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764012211",
            "telephone_number": "254-965-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIPPREY",
        "first_name": "TINA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-30",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "101000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "81S921",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295834001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stephenville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; 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.