Active NPI
Katrina Blanton, MS, CCC-SLP
- Speech-Language Pathologist
- Weatherford, TX
National Provider Identifier
1811292519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 108893
- Practice address
- 150 Willow Creek Dr
Weatherford, TX 76085-3651 - Phone
- (817) 550-5058
- NPI assigned
- Jan 11, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | 35914 | TX | |
| Speech-Language Pathologist | 235Z00000X | 108893 | TX | Primary |
Addresses
Primary practice location
150 Willow Creek Dr
Weatherford, TX 76085-3651
Mailing address
250 Sante Fe Dr
Weatherford, TX 76087
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 149984001 | Medicaid | TX | |
| 207164901 | Medicaid | TX |
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 |
|---|---|---|---|
| 35914 | TX | MD | Oral and Maxillofacial Surgery (Dentist) |
| 108893 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410998400000",
"number": "1811292519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 SANTE FE DR",
"city": "WEATHERFORD",
"state": "TX",
"postal_code": "76087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 WILLOW CREEK DR",
"city": "WEATHERFORD",
"state": "TX",
"postal_code": "760853651",
"telephone_number": "817-550-5058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLANTON",
"first_name": "KATRINA",
"credential": "MS, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-11",
"last_updated": "2014-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "TX",
"license": "35914",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "108893",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "149984001",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "207164901",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Weatherford, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.