Active NPI
Merlie Tameika Anderson, CCC-SLP
- Speech-Language Pathologist
- Fort Worth, TX
National Provider Identifier
1104131507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 105715
- Practice address
- 4300 Dulles Dr
13307
Fort Worth, TX 76155-2575 - Phone
- (404) 989-6408
- NPI assigned
- Aug 10, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 105715 | TX | Primary |
Addresses
Primary practice location
4300 Dulles Dr
13307
Fort Worth, TX 76155-2575
Mailing address
4300 Dulles Dr
13307
Fort Worth, TX 76155-2575
Phone (404) 989-6408
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105715 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376352000000",
"number": "1104131507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 DULLES DR",
"address_2": "13307",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761552575",
"telephone_number": "404-989-6408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 DULLES DR",
"address_2": "13307",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761552575",
"telephone_number": "404-989-6408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "MERLIE",
"middle_name": "TAMEIKA",
"name_prefix": "Ms.",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-08-10",
"last_updated": "2013-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "105715",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.