Individual provider Active NPI

Janice B Yeary, MSE, CCC, SLP

  • Speech-Language Pathologist
  • Fort Worth, TX
National Provider Identifier
1497986392
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
15381 Issued in TX
Practice address
3901 W Vickery Blvd
Suite #1
Fort Worth, TX 76107-5672
Phone
(817) 247-0654
Fax
(817) 847-0205
NPI assigned
Jul 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2012

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 15381 TX Primary

Addresses

Primary practice location

3901 W Vickery Blvd
Suite #1
Fort Worth, TX 76107-5672

Mailing address

PO Box 100722
Fort Worth, TX 76185-0722
Phone (817) 247-0654

Other identifiers 2

IdentifierTypeStateIssuer
80T421OtherTXBLUE CROSS BLUE SHIELD
203986901MedicaidTX

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
15381TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Carter Therapy 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331164800000",
    "number": "1497986392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100722",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761850722",
            "telephone_number": "817-247-0654",
            "fax_number": "817-847-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 W VICKERY BLVD",
            "address_2": "SUITE #1",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761075672",
            "telephone_number": "817-247-0654",
            "fax_number": "817-847-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEARY",
        "first_name": "JANICE",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "MSE, CCC, SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-27",
        "last_updated": "2012-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "15381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "80T421",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203986901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; 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.