Individual provider Active NPI

Theresa Rose Visintine, SLP

  • Speech-Language Pathologist
  • Saint Louis, MO
National Provider Identifier
1962992545
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2018015905 Issued in MO
Practice address
6022 S Lindbergh Blvd
Saint Louis, MO 63123-7029
Phone
(314) 845-7751
NPI assigned
May 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 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 2018015905 MO Primary

Addresses

Primary practice location

6022 S Lindbergh Blvd
Saint Louis, MO 63123-7029

Mailing address

6033 Pernod Ave
Saint Louis, MO 63139-1908
Phone (314) 401-6226

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

LicenseStateTypeSpecialty
2018015905MOMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
P.S. Kids, LLC Speech-Language Pathologist Past Accepting new patients
SSM Select Rehab St. Louis, LLC Past Accepting new patients

Organizations & group practices 2

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": "1526601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526601600000",
    "number": "1962992545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6033 PERNOD AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631391908",
            "telephone_number": "314-401-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6022 S LINDBERGH BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631237029",
            "telephone_number": "314-845-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISINTINE",
        "first_name": "THERESA",
        "middle_name": "ROSE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-18",
        "last_updated": "2018-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2018015905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.