NPIMap

Organization Active NPI

Blue Sky Speech and Feeding Therapy PLLC

  • Hearing and Speech Clinic/Center
  • Fort Worth, TX
National Provider Identifier
1629839386
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X
Legal business name
BLUE SKY SPEECH AND FEEDING THERAPY PLLC
Practice address
3621 Winifred Dr
Fort Worth, TX 76133-2126
Phone
(618) 792-8034
NPI assigned
Jan 19, 2024
Last updated
Jan 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Authorized official

Name
Jessica Marie Moore, CCC-SLPNPI 1194182881
Title
Owner
Phone
(618) 792-8034

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing and Speech Clinic/Center 261QH0700X NU Primary

Addresses

Primary practice location

3621 Winifred Dr
Fort Worth, TX 76133-2126

Mailing address

3621 Winifred Dr
Fort Worth, TX 76133-2126
Phone (618) 792-8034

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1705622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1629839386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 WINIFRED DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761332126",
            "telephone_number": "618-792-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3621 WINIFRED DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761332126",
            "telephone_number": "618-792-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SKY SPEECH AND FEEDING THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-792-8034",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 19, 2024; 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.