Individual provider Active NPI

Caley Nichole Quinn

  • Speech-Language Pathologist
  • Dallas, TX
National Provider Identifier
1497324180
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
114052 Issued in TX
Practice address
10405 E Northwest Hwy Ste 302
Dallas, TX 75238-4601
Phone
(972) 755-9157
Fax
(972) 759-9057
NPI assigned
Jun 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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 114052 TX Primary

Addresses

Primary practice location

10405 E Northwest Hwy Ste 302
Dallas, TX 75238-4601

Mailing address

2222 Moser Ave # 115
Dallas, TX 75206-7028
Phone (972) 979-2913

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
114052TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kid Pro, PLLC CurrentSince Jun 22, 2021 Accepting new patients

Locations

10405 E Northwest Hwy
Ste 302
Dallas, TX 75238
Phone (972) 755-9157

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": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1497324180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 MOSER AVE # 115",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752067028",
            "telephone_number": "972-979-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10405 E NORTHWEST HWY STE 302",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752384601",
            "telephone_number": "972-755-9157",
            "fax_number": "972-759-9057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINN",
        "first_name": "CALEY",
        "middle_name": "NICHOLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-18",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "114052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.