Individual provider Active NPI

Chelsea Rene Sanders, MS, CCC-SLP

  • Speech-Language Pathologist
  • Fort Worth, TX
National Provider Identifier
1841538972
Registry record updated Nov 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
109017 Issued in TX
Practice address
6036 Worrell Dr
Fort Worth, TX 76133
Phone
(325) 725-1983
NPI assigned
Jan 24, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2018

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 109017 TX Primary

Addresses

Primary practice location

6036 Worrell Dr
Fort Worth, TX 76133

Mailing address

6036 Worrell Dr
Fort Worth, TX 76133-2844
Phone (325) 725-1983

Other practice location 1

6202 Iola Ave
Suite 109
Lubbock, TX 79424-2728
Phone (800) 340-4098

Other identifiers 2

IdentifierTypeStateIssuer
149984001MedicaidTX
207164901MedicaidTX

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
109017TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1841538972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6036 WORRELL DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761332844",
            "telephone_number": "325-725-1983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6036 WORRELL DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76133",
            "telephone_number": "325-725-1983"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6202 Iola Ave",
            "address_2": "SUITE 109",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794242728",
            "country_code": "US",
            "telephone_number": "800-340-4098",
            "fax_number": "817-789-6849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "CHELSEA",
        "middle_name": "RENE",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-24",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "109017",
            "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 Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; 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.