Individual provider Active NPI

Andrea Kong, M.S.CCC-SLP

  • Speech-Language Pathologist
  • Houston, TX
National Provider Identifier
1154164267
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
121681 Issued in TX
Practice address
2990 Richmond Ave Ste 180
Houston, TX 77098-3116
Phone
(281) 829-0103
NPI assigned
Jun 17, 2024
Last updated
Jun 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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 121681 TX Primary

Addresses

Primary practice location

2990 Richmond Ave Ste 180
Houston, TX 77098-3116

Mailing address

12625 Memorial Dr Apt 145
Houston, TX 77024-4878
Phone (713) 469-1435

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

LicenseStateTypeSpecialty
121681TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Momentum Therapy Center, PLLC Speech-Language Pathologist CurrentSince Jun 23, 2024 Accepting new patients

Locations

2990 Richmond Ave
Ste 180
Houston, TX 77098
Phone (281) 829-0103

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, 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": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1154164267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12625 MEMORIAL DR APT 145",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770244878",
            "telephone_number": "713-469-1435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 RICHMOND AVE STE 180",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770983116",
            "telephone_number": "281-829-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONG",
        "first_name": "ANDREA",
        "credential": "M.S.CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "121681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.