Ainsley P. Vergara, M.ED., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP10644 Issued in AZ

Practice address

110 Carlton St.
593 Aderhold
Athens, GA 30602

Phone

(706) 542-4598

NPI assigned

Jul 19, 2017

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

Other names 1

• Ainsley Nicole P Former name

Medicare fee-for-service enrollment

Enrolled in AZ, GA2 enrollments

Enrollment records 2

Specialty

Qualified Speech Language Pathologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Board of Regents of the University System of GeorgiaGroup PAC ID 8729060967, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

Practice roles

Locations

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.

• Board of Regents of the University System of Georgia

  • Audiologist
  • Athens, GA
  • NPI 1376640557

  Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD
• Heartland Therapy, Inc.

  • Home Health Agency
  • Mesa, AZ
  • NPI 1962552547
  Medicare reassignment NPD
• Northern Arizona University

  • Audiologist-Hearing Aid Fitter
  • Flagstaff, AZ
  • NPI 1912950486
  Medicare reassignment NPD
• Theracare PLLC

  • Occupational Therapist
  • Peoria, AZ
  • NPI 1962784249

  Speech-Language Pathologist

  Medicare reassignment NPD
• Board of Regents of the University System of Georgia

  • Pharmacy
  • Athens, GA
  • NPI 1629394820
  NPD
• Az BD of Regents for on Behalf of Northern Az University

  • Primary Care Clinic/Center
  • Flagstaff, AZ
  • NPI 1891727863
  NPD
• Northern Arizona University

  • Speech-Language Pathologist
  • Flagstaff, AZ
  • NPI 1629581814
  NPD

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1043733280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 HIDDEN SPRING WAY",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306055746",
            "telephone_number": "478-357-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CARLTON ST.",
            "address_2": "593 ADERHOLD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "30602",
            "telephone_number": "706-542-4598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7677 W Bethany Home Rd",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853034211",
            "country_code": "US",
            "telephone_number": "478-357-5353",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7355 W Orangewood Ave",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "85303",
            "country_code": "US",
            "telephone_number": "478-357-5353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERGARA",
        "first_name": "AINSLEY",
        "middle_name": "P.",
        "name_prefix": "Mrs.",
        "credential": "M.ED., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP10644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AINSLEY",
            "last_name": "P",
            "middle_name": "NICOLE",
            "credential": "M.ED., CF-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Athens, GA
• Providers in Athens, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.