Active NPI
Cindy Russell, SPEECH PATHOLOGIST
- Speech-Language Pathologist
- Roanoke, TX
National Provider Identifier
1568889913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 12595
- Practice address
- 212 N Oak St
Roanoke, TX 76262-7000 - Phone
- (817) 797-0315
- NPI assigned
- Mar 24, 2014
- Last updated
- Mar 24, 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 | 12595 | TX | Primary |
Addresses
Primary practice location
212 N Oak St
Roanoke, TX 76262-7000
Mailing address
212 N Oak St
Roanoke, TX 76262-7000
Phone (817) 797-0315
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 |
|---|---|---|---|
| 12595 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395619200000",
"number": "1568889913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "212 N OAK ST",
"city": "ROANOKE",
"state": "TX",
"postal_code": "762627000",
"telephone_number": "817-797-0315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "212 N OAK ST",
"city": "ROANOKE",
"state": "TX",
"postal_code": "762627000",
"telephone_number": "817-797-0315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "CINDY",
"name_prefix": "Mrs.",
"credential": "SPEECH PATHOLOGIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-24",
"last_updated": "2014-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "12595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roanoke, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.