Active NPI
Christa Lynn Richbourg, ST
- Speech-Language Pathologist
- Palestine, TX
National Provider Identifier
1902058076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 100334
- Practice address
- 1007 E Park Ave
Palestine, TX 75801-4500 - Phone
- (903) 731-8000
- NPI assigned
- Oct 21, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 100334 | TX | Primary |
Addresses
Primary practice location
1007 E Park Ave
Palestine, TX 75801-4500
Mailing address
656 Acr 167
Elkhart, TX 75839
Phone (903) 279-5478
Other practice location 1
101 West Jefferson
Trinity, TX 75862-0752
Phone (936) 594-3569
Other practice location 2
656 Acr 167
Elkhart, TX 75839
Phone (903) 279-5478
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100334 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trinity Isd | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Local Education Agency (LEA)
- Trinity, TX
- NPI 1760672505
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664236800000",
"number": "1902058076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "656 ACR 167",
"city": "ELKHART",
"state": "TX",
"postal_code": "75839",
"telephone_number": "903-279-5478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1007 E PARK AVE",
"city": "PALESTINE",
"state": "TX",
"postal_code": "758014500",
"telephone_number": "903-731-8000"
}
],
"practiceLocations": [
{
"address_1": "101 West Jefferson",
"address_purpose": "LOCATION",
"city": "Trinity",
"state": "TX",
"postal_code": "758620752",
"country_code": "US",
"telephone_number": "936-594-3569",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "656 ACR 167",
"address_purpose": "LOCATION",
"city": "Elkhart",
"state": "TX",
"postal_code": "75839",
"country_code": "US",
"telephone_number": "903-279-5478",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RICHBOURG",
"first_name": "CHRISTA",
"middle_name": "LYNN",
"credential": "ST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-21",
"last_updated": "2022-09-27",
"certification_date": "2021-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "100334",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Palestine, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.