Individual provider Active NPI

Carolina Ross, M.S. CCC-SLP

  • Speech-Language Pathologist
  • San Antonio, TX
National Provider Identifier
1437532942
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
110679 Issued in TX
Practice address
5802 S Presa St
San Antonio, TX 78223-3506
Phone
(210) 261-3300
Fax
(210) 532-6090
NPI assigned
Jul 1, 2015
Last updated
Jan 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 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 Pathologist 235Z00000X 110679 TX Primary

Addresses

Primary practice location

5802 S Presa St
San Antonio, TX 78223-3506

Mailing address

6800 Park Ten Blvd Ste 200S
San Antonio, TX 78213-4293
Phone (210) 261-1000

Other names 1

  • Carolina Jardon Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
110679TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kidtherapy, PLLC Speech-Language Pathologist Past Accepting new patients
Bexar County Board of Trustees for Mental Health Mental Retardation PastSince Jan 12, 2020 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1437532942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 PARK TEN BLVD STE 200S",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782134293",
            "telephone_number": "210-261-1000",
            "fax_number": "210-261-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5802 S PRESA ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782233506",
            "telephone_number": "210-261-3300",
            "fax_number": "210-532-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "CAROLINA",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "110679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLINA",
            "last_name": "JARDON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.