Individual provider Active NPI

Grace Elexandra Hanna, CF-SLP

  • Speech-Language Pathologist
  • Bryan, TX
National Provider Identifier
1497217897
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
115096 Issued in TX
Practice address
801 S Ennis St
Bryan, TX 77803-4642
Phone
(979) 209-1000
NPI assigned
Apr 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 115096 TX Primary

Addresses

Primary practice location

801 S Ennis St
Bryan, TX 77803-4642

Mailing address

14153 Running Deer TRL
Austin, TX 78734-3038
Phone (512) 466-4713

Other practice location 1

2100 E Martin Luther King Jr Blvd
Austin, TX 78702-1342
Phone (512) 900-7934

Other identifiers 1

IdentifierTypeStateIssuer
115096MedicaidTX

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
115096TXMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sonrisas Therapies- Pediatric Home and Healthcare Services, LLC. 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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1497217897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14153 RUNNING DEER TRL",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787343038",
            "telephone_number": "512-466-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S ENNIS ST",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778034642",
            "telephone_number": "979-209-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 E Martin Luther King Jr Blvd",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787021342",
            "country_code": "US",
            "telephone_number": "512-900-7934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANNA",
        "first_name": "GRACE",
        "middle_name": "ELEXANDRA",
        "credential": "CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "115096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115096",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.