Active NPI
Kevin Renz Ambrocio, M.S., CCC-SLP
- Speech-Language Pathologist
- Austin, TX
National Provider Identifier
1760023238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 114435
- Practice address
- 1500 Red River St
Austin, TX 78701-1918 - Phone
- (512) 324-7000
- NPI assigned
- Oct 4, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 114435 | TX | Primary |
Addresses
Primary practice location
1500 Red River St
Austin, TX 78701-1918
Mailing address
610 Butcher St Apt H
New Braunfels, TX 78130-5759
Phone (210) 268-6475
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114435 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589500800000",
"number": "1760023238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 BUTCHER ST APT H",
"city": "NEW BRAUNFELS",
"state": "TX",
"postal_code": "781305759",
"telephone_number": "210-268-6475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 RED RIVER ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787011918",
"telephone_number": "512-324-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMBROCIO",
"first_name": "KEVIN",
"middle_name": "RENZ",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-10-04",
"last_updated": "2020-05-15",
"certification_date": "2020-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "114435",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.