Individual provider Active NPI

Nelly Lillie, CF-SLP

  • Speech-Language Pathologist
  • Pearland, TX
National Provider Identifier
1154069656
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
119554 Issued in TX
Practice address
2011 Broadway St Ste 130
Pearland, TX 77581-5945
Phone
(281) 997-8509
NPI assigned
May 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 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 119554 TX Primary

Addresses

Primary practice location

2011 Broadway St Ste 130
Pearland, TX 77581-5945

Mailing address

1119 W 2ND St
Elgin, TX 78621-2034
Phone (956) 652-6767

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
119554TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverkids Houston Therapy, LLC PastSince Sep 23, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1154069656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 W 2ND ST",
            "city": "ELGIN",
            "state": "TX",
            "postal_code": "786212034",
            "telephone_number": "956-652-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 BROADWAY ST STE 130",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775815945",
            "telephone_number": "281-997-8509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLIE",
        "first_name": "NELLY",
        "name_prefix": "Ms.",
        "credential": "CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-24",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "119554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; 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.