Individual provider Active NPI

Olivia Fearon

  • Speech-Language Pathologist
  • Houston, TX
National Provider Identifier
1396316113
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
118361 Issued in TX
Practice address
3100 Shenandoah St
Houston, TX 77021-1042
Phone
(713) 523-3633
NPI assigned
Jul 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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 118361 TX Primary

Addresses

Primary practice location

3100 Shenandoah St
Houston, TX 77021-1042

Mailing address

3100 Shenandoah St
Houston, TX 77021-1042
Phone (713) 523-3633

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230324000054 TX Practitioner - Qualified Speech Language Pathologist 6608240197 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
118361TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Hearing and Speech Speech-Language Pathologist CurrentSince Dec 10, 2022 Accepting new patients

Locations

3100 Shenandoah St
Houston, TX 77021
Phone (713) 523-3633

12300 Parc Crest Dr
Ste 166
Stafford, TX 77477
Phone (713) 337-6419

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1625184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1396316113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SHENANDOAH ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770211042",
            "telephone_number": "713-523-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SHENANDOAH ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770211042",
            "telephone_number": "713-523-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEARON",
        "first_name": "OLIVIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-02",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "118361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.