Active NPI
Nina Veniaminovna Ivanova
- Speech-Language Assistant
- Bedford, TX
National Provider Identifier
1437650678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 38389
- Practice address
- 2350 Airport Fwy Ste 150
Bedford, TX 76022-6050 - Phone
- (817) 508-0030
- NPI assigned
- Feb 22, 2018
- Sex
- Female
- Sole proprietor
- No
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 Assistant | 2355S0801X | 38389 | TX | Primary |
Addresses
Primary practice location
2350 Airport Fwy Ste 150
Bedford, TX 76022-6050
Mailing address
2350 Airport Fwy Ste 150
Bedford, TX 76022-6050
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 |
|---|---|---|---|
| 38389 | TX | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1437650678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2350 AIRPORT FWY STE 150",
"city": "BEDFORD",
"state": "TX",
"postal_code": "760226050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2350 AIRPORT FWY STE 150",
"city": "BEDFORD",
"state": "TX",
"postal_code": "760226050",
"telephone_number": "817-508-0030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IVANOVA",
"first_name": "NINA",
"middle_name": "VENIAMINOVNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-22",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "TX",
"license": "38389",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bedford, TX
- Asha Daniella Inniss, NP
- Integrated Trauma Solutions LLC
- Intellection Consulting, LLC
- Stephanie McCoy Irizarry, PT CWS RMT MLT
- Ali Ishaque, M.D
- J. D. Bell, M.D., P.a.
- Ommara Shereen Jabbar, MD
- Jack Jones Hearing Centers, Inc.
- Mahalia L Jackson-Butler, DNP, APRN
- Antonious Dewayne Jackson, D.C., F.N.P-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.