Individual provider Active NPI

Foster Ellis, M.S. CF-SLP

  • Speech-Language Pathologist
  • Dallas, TX
National Provider Identifier
1245006477
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
120956 Issued in TX
Practice address
12880 Hillcrest Rd Ste 102
Dallas, TX 75230-1501
Phone
(972) 387-1100
NPI assigned
Nov 29, 2023
Last updated
Nov 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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 120956 TX Primary

Addresses

Primary practice location

12880 Hillcrest Rd Ste 102
Dallas, TX 75230-1501

Mailing address

12880 Hillcrest Rd Ste 102
Dallas, TX 75230-1501
Phone (972) 387-1100

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
120956TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Playworks Pediatric Therapy Services Inc PastSince Dec 3, 2023 Accepting new patients
Amy C. Havenor Speech-Language Pathologist PastSince Dec 3, 2023 Accepting new patients

Organizations & group practices 2

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": "1701216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1245006477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12880 HILLCREST RD STE 102",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752301501",
            "telephone_number": "972-387-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12880 HILLCREST RD STE 102",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752301501",
            "telephone_number": "972-387-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "FOSTER",
        "credential": "M.S. CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-29",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "120956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.