Active NPI
Stephanie Colleen Carrillo, M.S., CCC-SLP
- Speech-Language Pathologist
- Lubbock, TX
National Provider Identifier
1487794517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 100284
- Practice address
- 5225 S Loop 289
Ste 210
Lubbock, TX 79424-1363 - Phone
- (806) 780-4180
- Fax
- (806) 744-7458
- NPI assigned
- Feb 7, 2007
- Last updated
- Jun 11, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | 100284 | TX | Primary |
Addresses
Primary practice location
5225 S Loop 289
Ste 210
Lubbock, TX 79424-1363
Mailing address
305 NE Loop 820
Business Tower 1, Ste 200
Hurst, TX 76053-7209
Phone (806) 780-4180
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
| License | State | Type | Specialty |
|---|---|---|---|
| 100284 | TX | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Epic Health Services, Inc. | Past | Accepting new patients | |
| Epic Health Services, Inc. | Past | 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": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402444800000",
"number": "1487794517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 NE LOOP 820",
"address_2": "BUSINESS TOWER 1, STE 200",
"city": "HURST",
"state": "TX",
"postal_code": "760537209",
"telephone_number": "806-780-4180",
"fax_number": "806-744-7458"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5225 S LOOP 289",
"address_2": "STE 210",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794241363",
"telephone_number": "806-780-4180",
"fax_number": "806-744-7458"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRILLO",
"first_name": "STEPHANIE",
"middle_name": "COLLEEN",
"name_prefix": "Mrs.",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-07",
"last_updated": "2014-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "100284",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.