Madison Faris, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

117071 Issued in TX

Practice address

3701 Garden Springs Dr
Fort Worth, TX 76123-2375

Phone

(817) 370-5600

NPI assigned

Jul 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• CKC Holdings LLC

  dba Cornerstone Pediatric Therapy

  • Home Health Agency
  • Arlington, TX
  • NPI 1023310901
  NPD (past)
• CKC Holdings LLC

  dba Cornerstone Pediatric Therapy

  • Behavior Analyst
  • Carrollton, TX
  • NPI 1538815055
  NPD (past)

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1376029132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 BELLAIRE RANCH DR APT 136",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091850",
            "telephone_number": "817-988-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 GARDEN SPRINGS DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761232375",
            "telephone_number": "817-370-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARIS",
        "first_name": "MADISON",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-16",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "TX",
            "license": "40678",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "117071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Beth Faram, NURSE PRACTITIONER
• Francine Farber
• Victoria Hassard Farber, OTR
• Guillermo Augusto Farfan, MD
• Lisa Garrett Farhat, M.ED, LPC, RPT
• Kathryn Rose Farishta, PMHNP-BC
• Gina Renee Farkas, CCC/SLP
• Carson Farley
• David Samuel Farley, DC
• Meredith Farley, M.S., CCC-SLP

• Speech-Language Pathologist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; 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.