Individual provider Active NPI

Kristine R Marks, MS, CCC/SLP

  • Speech-Language Pathologist
  • Amarillo, TX
National Provider Identifier
1932948080
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
15701 Issued in TX
Practice address
1510 S Van Buren St
Amarillo, TX 79101-4130
Phone
(806) 337-4000
NPI assigned
May 20, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2024

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 15701 TX Primary

Addresses

Primary practice location

1510 S Van Buren St
Amarillo, TX 79101-4130

Mailing address

9111 Lundy LN
Amarillo, TX 79119-5810

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240815002733 TX Practitioner - Qualified Speech Language Pathologist 1153869599 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15701TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Century Rehabilitation of Texas LLC Speech-Language Pathologist CurrentSince Jun 1, 2024 Accepting new patients

Locations

4703 Bluebonnet Blvd
Baton Rouge, LA 70809
Phone (225) 761-2222

1510 S Van Buren St
Amarillo, TX 79101
Phone (806) 337-4000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1932948080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9111 LUNDY LN",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791195810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 S VAN BUREN ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791014130",
            "telephone_number": "806-337-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS",
        "first_name": "KRISTINE",
        "middle_name": "R",
        "credential": "MS, CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "15701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.