Active NPI
Pamela Marie Hanson, M.S. CCC/SLP AVT
- Speech-Language Pathologist
- Las Vegas, NV
National Provider Identifier
1467567107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP-170
- Practice address
- 6701 W Charleston Blvd # 26
Las Vegas, NV 89146 - Phone
- (702) 341-8352
- Fax
- (702) 341-8365
- NPI assigned
- Aug 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP-170 | NV | Primary |
Addresses
Primary practice location
6701 W Charleston Blvd # 26
Las Vegas, NV 89146
Mailing address
9420 Calico Garden Ave
Las Vegas, NV 89134-0164
Phone (702) 215-9382
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003402059 | Medicaid | NV |
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
| License | State | Type | Specialty |
|---|---|---|---|
| SP-170 | NV | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| T.a.L.K.Specialists, LLC | Speech-Language Pathologist | Past | Accepting new patients |
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": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673222400000",
"number": "1467567107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9420 CALICO GARDEN AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891340164",
"telephone_number": "702-215-9382",
"fax_number": "702-341-8365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6701 W CHARLESTON BLVD # 26",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89146",
"telephone_number": "702-341-8352",
"fax_number": "702-341-8365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSON",
"first_name": "PAMELA",
"middle_name": "MARIE",
"credential": "M.S. CCC/SLP AVT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-21",
"last_updated": "2023-01-09",
"certification_date": "2023-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NV",
"license": "SP-170",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003402059",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.