Individual provider Active NPI

Lynn Gazaway Roebuck, M. S., CCC-SLP

  • Speech-Language Pathologist
  • Birmingham, AL
National Provider Identifier
1003044363
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1592 Issued in AL
Practice address
120 Oslo Cir
Birmingham, AL 35211-5965
Phone
(205) 944-3939
NPI assigned
Jun 25, 2009
Last updated
May 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2019

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 1592 AL Primary

Addresses

Primary practice location

120 Oslo Cir
Birmingham, AL 35211-5965

Mailing address

120 Oslo Cir
Birmingham, AL 35211-5965

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200125000103 AL Practitioner - Qualified Speech Language Pathologist 9830524636 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1592ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
United Ability Inc CurrentSince Aug 7, 2019 Accepting new patients
United Ability Inc Current Accepting new patients
United Ability Inc Past Accepting new patients

Locations

100 Oslo Cir
Birmingham, AL 35211
Phone (205) 944-3900

120 Oslo Cir
Birmingham, AL 35211
Phone (205) 944-3939

8601 Old Highway 31
Morris, AL 35116
Phone (205) 944-3944

Organizations & group practices 3

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": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1003044363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 OSLO CIR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352115965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 OSLO CIR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352115965",
            "telephone_number": "205-944-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEBUCK",
        "first_name": "LYNN",
        "middle_name": "GAZAWAY",
        "name_prefix": "Ms.",
        "credential": "M. S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": "1592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.