Mary Grace Rayburn

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

104826 Issued in TX

Practice address

1 Medical Plaza
Pampa, TX 79065

Phone

(806) 663-5566

NPI assigned

Jan 11, 2022

Last updated

Jan 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1033860168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 CHRISTINE ST",
            "city": "PAMPA",
            "state": "TX",
            "postal_code": "790654430",
            "telephone_number": "940-395-5991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PLAZA",
            "city": "PAMPA",
            "state": "TX",
            "postal_code": "79065",
            "telephone_number": "806-663-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYBURN",
        "first_name": "MARY",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "104826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prime Healthcare Services Pampa LLC (Pampa Medical Group)
• Prime Healthcare Services Pampa LLC (Pampa Regional Medical Center)
• Prime Healthcare Services Pampa LLC (Pampa Regional Medical Center)
• Abby G Ramirez, FNP-C
• Ranch Road Inpatient Services
• Leah Dawn Redwine, M.S. CCC-SLP
• Rene P Grabato MD PA (The Urology Clinic)
• Raine Reyes, M. ED.
• Sara Richison
• Kellie Michele Roby, AGPCNP-BC

• Speech-Language Pathologist in Pampa, TX
• Providers in Pampa, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.

Verify at the official NPI Registry.