Individual provider Active NPI

Devin O Roscillo, MA, CCC/SLP

  • Speech-Language Pathologist
  • Killeen, TX
National Provider Identifier
1871097170
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
115368 Issued in TX
Practice address
1102 Winkler Ave
Killeen, TX 76542-6249
Phone
(254) 634-8505
Fax
(254) 781-4312
NPI assigned
Mar 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 115368 TX Primary
Speech-Language Pathologist 235Z00000X 5361 CT

Addresses

Primary practice location

1102 Winkler Ave
Killeen, TX 76542-6249

Mailing address

605 Donnie Ave
Killeen, TX 76541-8918
Phone (254) 634-8505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180417001691 CT Practitioner - Qualified Speech Language Pathologist 3476816836 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
115368TXMDOccupational Therapist
5361CTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prestige Rehab CT PLLC CurrentSince Apr 4, 2025 Accepting new patients
Barr Physical Therapy, P.C. Speech-Language Pathologist Past Accepting new patients
Barr Physical Therapy, P.C. Speech-Language Pathologist PastSince Dec 27, 2022 Accepting new patients
San Luis Walk-in Clinic, Inc. Past Accepting new patients
Empowered Voices LLC Speech-Language Pathologist Past Accepting new patients

Locations

36 Russ St
Fl 3
Hartford, CT 06106
Phone (301) 785-2099

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11823/brand/2/csg/41/fhir/r4

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1871097170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 DONNIE AVE",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765418918",
            "telephone_number": "254-634-8505",
            "fax_number": "254-781-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 WINKLER AVE",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765426249",
            "telephone_number": "254-634-8505",
            "fax_number": "254-781-4312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSCILLO",
        "first_name": "DEVIN",
        "middle_name": "O",
        "credential": "MA, CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-21",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "115368",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "5361",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.