Individual provider Active NPI

Justin Worthy, SLP-ASSISTANT

  • Speech-Language Assistant
  • Houston, TX
National Provider Identifier
1578918397
Registry record updated Apr 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
36072 Issued in TN
Practice address
6666 Harwin Dr
Houston, TX 77036-2292
Phone
(713) 429-1176
NPI assigned
Apr 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 36072 TN Primary

Addresses

Primary practice location

6666 Harwin Dr
Houston, TX 77036-2292

Mailing address

9767 Pagewood LN
Apt 616
Houston, TX 77042-5518
Phone (413) 636-2450

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
36072TNMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461888000000",
    "number": "1578918397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9767 PAGEWOOD LN",
            "address_2": "APT 616",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770425518",
            "telephone_number": "413-636-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6666 HARWIN DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770362292",
            "telephone_number": "713-429-1176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTHY",
        "first_name": "JUSTIN",
        "credential": "SLP-ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-29",
        "last_updated": "2016-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "TN",
            "license": "36072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; 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.