Individual provider Active NPI

Lindsey Castillo, SLP

  • Speech-Language Pathologist
  • Fort Worth, TX
National Provider Identifier
1487343588
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
206918 Issued in AK
Practice address
4108 Mattison Ave
Fort Worth, TX 76107-2411
Phone
(817) 692-5710
NPI assigned
May 4, 2023
Last updated
Dec 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 118247 TX
Speech-Language Pathologist 235Z00000X 206918 AK Primary

Addresses

Primary practice location

4108 Mattison Ave
Fort Worth, TX 76107-2411

Mailing address

36275 Kenai Spur Hwy Ste 1
Soldotna, AK 99669-7157

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230901001092 TX Practitioner - Qualified Speech Language Pathologist 3678936093 Reassigns benefits to 1 organization
I20231025001601 AK Practitioner - Qualified Speech Language Pathologist 3678936093 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
118247TXMDOccupational Therapist
206918AKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pain and Headache Center, LLC CurrentSince Jun 15, 2023 Accepting new patients

Locations

1901 N Hemmer Rd
Apt 111
Palmer, AK 99645
Phone (907) 745-8000

36275 Kenai Spur Hwy
Ste 1
Soldotna, AK 99669
Phone (907) 420-0565

851 E Westpoint Dr
Ste B6
Wasilla, AK 99654
Phone (907) 357-3740

425 Alabama Ave
Ft Worth, TX 76104
Phone (817) 820-3400

6601 Harris Pkwy
Ft Worth, TX 76132
Phone (817) 433-9600

4851 Regent Blvd
Ste 200
Irving, TX 75063
Phone (972) 580-8500

Organizations & group practices 1

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": "1683158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1487343588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36275 KENAI SPUR HWY STE 1",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4108 MATTISON AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072411",
            "telephone_number": "817-692-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "LINDSEY",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-04",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "118247",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AK",
            "license": "206918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.