Individual provider Active NPI

Courtney Scott Bauer, MA, CCC-SLP

  • Speech-Language Pathologist
  • Southaven, MS
National Provider Identifier
1306962600
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
S3071 Issued in MS
Practice address
5779 Getwell Rd
BLDG. D, Suite 3
Southaven, MS 38672-6347
Phone
(662) 510-6507
Fax
(662) 510-6508
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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 S3071 MS Primary

Addresses

Primary practice location

5779 Getwell Rd
BLDG. D, Suite 3
Southaven, MS 38672-6347

Mailing address

8680 Bell Ridge Dr
Olive Branch, MS 38654-6223
Phone (662) 895-4555

Other identifiers 1

IdentifierTypeStateIssuer
07834592MedicaidMS

Other names 1

  • Miss Courtney Marie Scott Former name

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 Arts

State licenses

LicenseStateTypeSpecialty
S3071MSMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1306962600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8680 BELL RIDGE DR",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386546223",
            "telephone_number": "662-895-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5779 GETWELL RD",
            "address_2": "BLDG. D, SUITE 3",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386726347",
            "telephone_number": "662-510-6507",
            "fax_number": "662-510-6508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "COURTNEY",
        "middle_name": "SCOTT",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S3071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07834592",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "SCOTT",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "MA, CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; 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.