NPIMap

Organization Active NPI

Speech Pathology Associates, Inc.

  • Speech-Language Pathologist
  • Bogue Chitto, MS
National Provider Identifier
1073676623
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
SPEECH PATHOLOGY ASSOCIATES, INC.
Practice address
20 The Rays TRL SE
Bogue Chitto, MS 39629-8500
Phone
(601) 833-8363
Fax
(601) 833-0080
NPI assigned
Dec 18, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Beverly N Ray, CCC-SLPNPI 1316000961
Title
President
Phone
(601) 833-8363

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

20 The Rays TRL SE
Bogue Chitto, MS 39629-8500

Mailing address

20 The Rays TRL SE
Bogue Chitto, MS 39629-8500
Phone (601) 833-8363

Other identifiers 1

IdentifierTypeStateIssuer
09016222MedicaidMS

National Provider Directory

National Provider Directory

Locations

20 The Rays Trl SE
Bogue Chitto, MS 39629
Phone (601) 833-8363

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073676623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 THE RAYS TRL SE",
            "city": "BOGUE CHITTO",
            "state": "MS",
            "postal_code": "396298500",
            "telephone_number": "601-833-8363",
            "fax_number": "601-833-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 THE RAYS TRL SE",
            "city": "BOGUE CHITTO",
            "state": "MS",
            "postal_code": "396298500",
            "telephone_number": "601-833-8363",
            "fax_number": "601-833-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH PATHOLOGY ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-833-8363",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09016222",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bogue Chitto, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.