Active NPI
Stephanie Utley, SLP
- Speech-Language Pathologist
- Weatherford, TX
National Provider Identifier
1487739488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 19755
- Practice address
- 216 Lake Hollow Dr
Weatherford, TX 76087-8007 - Phone
- (817) 550-5058
- Fax
- (817) 550-8177
- NPI assigned
- Oct 26, 2006
- 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 Pathologist | 235Z00000X | 19755 | TX | Primary |
Addresses
Primary practice location
216 Lake Hollow Dr
Weatherford, TX 76087-8007
Mailing address
216 Lake Hollow Dr
Weatherford, TX 76087-8007
Phone (817) 550-5058
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 80T581 | Other | TX | BCBS |
| 147819002 | Medicaid | TX |
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 |
|---|---|---|---|
| 19755 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Green Apple LLC | Current | 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 and National Provider Directory roles.
-
- Home Health Agency
- Irving, TX
- NPI 1306170576
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270425600000",
"number": "1487739488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "216 LAKE HOLLOW DR",
"city": "WEATHERFORD",
"state": "TX",
"postal_code": "760878007",
"telephone_number": "817-550-5058",
"fax_number": "817-550-8177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 LAKE HOLLOW DR",
"city": "WEATHERFORD",
"state": "TX",
"postal_code": "760878007",
"telephone_number": "817-550-5058",
"fax_number": "817-550-8177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UTLEY",
"first_name": "STEPHANIE",
"name_prefix": "Ms.",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-26",
"last_updated": "2010-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "19755",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "80T581",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "147819002",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Weatherford, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.