Individual provider Active NPI

Amelia K Mitchell, SLP

  • Speech-Language Pathologist
  • Greenville, TX
National Provider Identifier
1164598959
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
100349 Issued in TX
Practice address
4804 Wesley St
Greenville, TX 75401-5650
Phone
(903) 454-0300
NPI assigned
Nov 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 100349 TX Primary

Addresses

Primary practice location

4804 Wesley St
Greenville, TX 75401-5650

Mailing address

400 Airport Rd
P O Box 747
Terrell, TX 75160-4302
Phone (972) 524-4159

Other identifiers 1

IdentifierTypeStateIssuer
8T1884OtherTXBCBS NUMBER

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
100349TXMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1164499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1164598959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 AIRPORT RD",
            "address_2": "P O BOX 747",
            "city": "TERRELL",
            "state": "TX",
            "postal_code": "751604302",
            "telephone_number": "972-524-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4804 WESLEY ST",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754015650",
            "telephone_number": "903-454-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "AMELIA",
        "middle_name": "K",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "100349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "8T1884",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.