Individual provider Active NPI

Dona Diane King, SLP

  • Speech-Language Pathologist
  • Livingston, TX
National Provider Identifier
1487661856
Registry record updated May 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146002991
Practice address
440 Highway 59 Loop S
Ste 104
Livingston, TX 77351-9096
Phone
(936) 328-8148
Fax
(936) 327-2491
NPI assigned
Aug 1, 2006
Last updated
May 15, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2013

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 146002991 Primary
Speech-Language Pathologist 235Z00000X 107336 TX

Addresses

Primary practice location

440 Highway 59 Loop S
Ste 104
Livingston, TX 77351-9096

Mailing address

830 Franklin St
Charleston, IL 61920-3129
Phone (217) 259-2953

Other identifiers 1

IdentifierTypeStateIssuer
0001532016OtherILBLUE CROSS BLUE SHIELD

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
107336TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Rehabilitation,LLC Speech-Language Pathologist Past Accepting new patients

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368576000000",
    "number": "1487661856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 FRANKLIN ST",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619203129",
            "telephone_number": "217-259-2953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 HIGHWAY 59 LOOP S",
            "address_2": "STE 104",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773519096",
            "telephone_number": "936-328-8148",
            "fax_number": "936-327-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "DONA",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2013-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "146002991",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "107336",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0001532016",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.