Individual provider Active NPI

Stacy Heinzig

  • Speech-Language Pathologist
  • Garland, TX
National Provider Identifier
1649995135
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
110198 Issued in TX
Practice address
501 S Jupiter Rd
Garland, TX 75042-7108
Phone
(972) 494-8201
NPI assigned
Oct 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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 110198 TX Primary

Addresses

Primary practice location

501 S Jupiter Rd
Garland, TX 75042-7108

Mailing address

5437 Naaman Forest Blvd Apt 903
Garland, TX 75044-5626
Phone (469) 556-5083

Other names 1

  • Stacy Hall Former name

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
110198TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1649995135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5437 NAAMAN FOREST BLVD APT 903",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750445626",
            "telephone_number": "469-556-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S JUPITER RD",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750427108",
            "telephone_number": "972-494-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEINZIG",
        "first_name": "STACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-06",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "110198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "HALL",
            "credential": "M.S., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Garland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.