Individual provider Active NPI

Carrie Elaine Oldbury, MS, CCC-SLP

  • Speech-Language Pathologist
  • Beaumont, TX
National Provider Identifier
1124583588
Registry record updated Feb 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
108494 Issued in TX
Practice address
795 Lindbergh Dr
Beaumont, TX 77707-3616
Phone
(409) 842-2228
NPI assigned
Feb 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2019

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 108494 TX Primary

Addresses

Primary practice location

795 Lindbergh Dr
Beaumont, TX 77707-3616

Mailing address

795 Lindbergh Dr
Beaumont, TX 77707-3616
Phone (409) 842-2228

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
108494TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1549584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549584000000",
    "number": "1124583588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 LINDBERGH DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777073616",
            "telephone_number": "409-842-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 LINDBERGH DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777073616",
            "telephone_number": "409-842-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDBURY",
        "first_name": "CARRIE",
        "middle_name": "ELAINE",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-08",
        "last_updated": "2019-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "108494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2019; 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.