Tina Romero Fahrenbrook, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2016003984 Issued in NE

Practice address

1900 Flaten Ave
Gering, NE 69341-1850

Phone

(308) 436-5555

NPI assigned

Nov 21, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Miss Tina Katherine Romero Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1679016869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 BEVERLY BLVD",
            "city": "GERING",
            "state": "NE",
            "postal_code": "693411914",
            "telephone_number": "308-436-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 FLATEN AVE",
            "city": "GERING",
            "state": "NE",
            "postal_code": "693411850",
            "telephone_number": "308-436-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHRENBROOK",
        "first_name": "TINA",
        "middle_name": "ROMERO",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "2016003984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23520000X",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "ROMERO",
            "middle_name": "KATHERINE",
            "prefix": "MISS",
            "credential": "M.A., SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Gering, NE
• Providers in Gering, NE by specialty
• Speech-Language Pathologist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.