Individual provider Active NPI

Amy Livingston, MS, CCC-SLP

  • Speech-Language Pathologist
  • Oxford, MS
National Provider Identifier
1245542299
Registry record updated Mar 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
S2355 Issued in MS
Practice address
104 Skyline Dr
Oxford, MS 38655-9781
Phone
(662) 380-5170
Fax
(662) 380-5271
NPI assigned
Jul 7, 2010
Last updated
Mar 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2020

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 S2355 MS Primary

Addresses

Primary practice location

104 Skyline Dr
Oxford, MS 38655-9781

Mailing address

104 Skyline Dr
Oxford, MS 38655-9781
Phone (662) 380-5170

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250117000746 MS Practitioner - Qualified Speech Language Pathologist 5294915799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

9684 Goodman Rd
Olive Branch, MS 38654-1726
Phone (662) 880-3334

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3706TNMDClinical Psychologist
S2355MSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Dec 23, 2024 Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist Current Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Dec 23, 2024 Accepting new patients
Educational Based Services Speech-Language Pathologist Past Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

Organizations & group practices 4

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": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583452800000",
    "number": "1245542299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 SKYLINE DR",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386559781",
            "telephone_number": "662-380-5170",
            "fax_number": "662-380-5271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 SKYLINE DR",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386559781",
            "telephone_number": "662-380-5170",
            "fax_number": "662-380-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVINGSTON",
        "first_name": "AMY",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-07",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S2355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.