Individual provider Active NPI

Elizabeth Marie Sampson, M.A., CCC/SLP

  • Speech-Language Pathologist
  • Friendswood, TX
National Provider Identifier
1396471389
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
105968 Issued in TX
Practice address
820 S Friendswood Dr Ste 100
Friendswood, TX 77546-4543
Phone
(281) 816-3067
Fax
(832) 569-4696
NPI assigned
Aug 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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 105968 TX Primary

Addresses

Primary practice location

820 S Friendswood Dr Ste 100
Friendswood, TX 77546-4543

Mailing address

699 S Friendswood Dr Ste 104
Friendswood, TX 77546-4580
Phone (281) 816-3067

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241126003162 TX Practitioner - Qualified Speech Language Pathologist 0941735039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Autumn Oak Speech Voice and HearingGroup PAC ID 5597915652, 5 clinicians

Practice addresses (Care Compare)

820 S Friendswood Dr
Suite 100
Friendswood, TX 77546-4543
Phone (281) 816-3067

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
105968TXMDSpeech-Language Pathologist

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": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1396471389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "699 S FRIENDSWOOD DR STE 104",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775464580",
            "telephone_number": "281-816-3067",
            "fax_number": "832-569-4696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S FRIENDSWOOD DR STE 100",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775464543",
            "telephone_number": "281-816-3067",
            "fax_number": "832-569-4696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPSON",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "credential": "M.A., CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-01",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "105968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Friendswood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.