Individual provider Active NPI

Elizabeth Anne Ambrose, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Sedalia, MO
National Provider Identifier
1386784403
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
112858 Issued in MO
Practice address
601 E 14TH St
Sedalia, MO 65301-5972
Phone
(660) 827-9136
Fax
(660) 829-0278
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 112858 MO Primary

Addresses

Primary practice location

601 E 14TH St
Sedalia, MO 65301-5972

Mailing address

6001 Chestnut Dr
Sedalia, MO 65301-8939
Phone (660) 826-7076

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
112858MOMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386784403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 CHESTNUT DR",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653018939",
            "telephone_number": "660-826-7076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E 14TH ST",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653015972",
            "telephone_number": "660-827-9136",
            "fax_number": "660-829-0278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSE",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "112858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sedalia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.