Individual provider Active NPI

Amy Ellis Naugher, MS CCC/SLP

  • Speech-Language Pathologist
  • Tulsa, OK
National Provider Identifier
1093012411
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3560 Issued in OK
Practice address
10045 S Lakewood Ave
Tulsa, OK 74137-5530
Phone
(903) 744-3374
NPI assigned
Feb 21, 2011
Last updated
Mar 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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 3560 OK Primary

Addresses

Primary practice location

10045 S Lakewood Ave
Tulsa, OK 74137-5530

Mailing address

10045 S Lakewood Ave
Tulsa, OK 74137-5530
Phone (903) 744-3374

Other names 1

  • Ms. Amy Ellis Pelley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200514000285 TX Practitioner - Qualified Speech Language Pathologist 3971858119 Reassigns benefits to 1 organization
I20221017003272 FL Practitioner - Qualified Speech Language Pathologist 3971858119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1221 Graham Dr
Tomball, TX 77375-6407
Phone (346) 222-3060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3560OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Great Therapy Group LLC Speech-Language Pathologist CurrentSince Aug 22, 2022 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Apr 1, 2020 Accepting new patients
Professional Dysphagia Specialists Speech-Language Pathologist Past Accepting new patients

Locations

3389 Sheridan St
Hollywood, FL 33021
Phone (954) 247-8757

8100 Precinct Line Rd
Colleyville, TX 76034
Phone (682) 244-4317

1850 E League City Pkwy
League City, TX 77573
Phone (364) 413-6110

265 Plateau Dr
McKinney, TX 75069
Phone (512) 277-6405

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": "1298246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1093012411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10045 S LAKEWOOD AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741375530",
            "telephone_number": "903-744-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10045 S LAKEWOOD AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741375530",
            "telephone_number": "903-744-3374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAUGHER",
        "first_name": "AMY",
        "middle_name": "ELLIS",
        "name_prefix": "Ms.",
        "credential": "MS CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-21",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "3560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "PELLEY",
            "middle_name": "ELLIS",
            "prefix": "MS.",
            "credential": "ST",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; 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.