Teresa Renae Anderle, M.S., C.C.C. / SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

15474 Issued in TX

Practice address

100 Cooke St
Nocona, TX 76255-2108

Phone

(940) 825-5061

NPI assigned

Jun 2, 2008

Last updated

Jul 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• My Health My Resources of Tarrant County

  dba MHMR of Tarrant County

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fort Worth, TX
  • NPI 1376590422
  NPD (past)

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1710145107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 VILLAGE ESTATES DR",
            "city": "HIGHLAND VILLAGE",
            "state": "TX",
            "postal_code": "750777118",
            "telephone_number": "469-222-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COOKE ST",
            "city": "NOCONA",
            "state": "TX",
            "postal_code": "762552108",
            "telephone_number": "940-825-5061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERLE",
        "first_name": "TERESA",
        "middle_name": "RENAE",
        "name_prefix": "Mrs.",
        "credential": "M.S., C.C.C. / SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "15474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004228503",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8ES492",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristi Atkison Barrett, M.S., P.T.
• Tyler John Lee Benson, D.O.
• Jae Berman, RDN
• Kimberly Michelle Bruhn, PT
• City Drug Store of Nocona Inc (Gibbs Drug Store)

• Speech-Language Pathologist in Nocona, TX
• Providers in Nocona, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.