Individual provider Active NPI

Amber Lynn Lingle Goff, M.S CCC-SLP

  • Speech-Language Pathologist
  • Conway, AR
National Provider Identifier
1164545661
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2428 Issued in AR
Practice address
2200 Bruce St. Ste 101
Conway, AR 72034
Phone
(501) 470-7457
Fax
(501) 504-2105
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 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 2428 AR Primary

Addresses

Primary practice location

2200 Bruce St. Ste 101
Conway, AR 72034

Mailing address

2200 Bruce St.
Ste 101
Conway, AR 72034
Phone (501) 470-7457

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220317000226 AR Practitioner - Qualified Speech Language Pathologist 4486049046 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2428ARMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Central Arkansas Current Accepting new patients
University of Central Arkansas Speech-Language Pathologist CurrentSince Jan 1, 2022 Accepting new patients
University of Central Arkansas Speech-Language Pathologist CurrentSince Mar 13, 2022 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1164545661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 BRUCE ST.",
            "address_2": "STE 101",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "72034",
            "telephone_number": "501-470-7457",
            "fax_number": "501-504-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BRUCE ST. STE 101",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "72034",
            "telephone_number": "501-470-7457",
            "fax_number": "501-504-2105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFF",
        "first_name": "AMBER",
        "middle_name": "LYNN LINGLE",
        "name_prefix": "Miss",
        "credential": "M.S CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "2428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.