Individual provider Active NPI

Diane Houston

  • Speech-Language Pathologist
  • Myrtle Beach, SC
National Provider Identifier
1467746933
Registry record updated Jun 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2291 Issued in SC
Practice address
4201 Carolina Exchange Dr
Suite 102
Myrtle Beach, SC 29579-4394
Phone
(843) 455-7505
NPI assigned
Jun 2, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2011

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 2291 SC Primary

Addresses

Primary practice location

4201 Carolina Exchange Dr
Suite 102
Myrtle Beach, SC 29579-4394

Mailing address

PO Box 1523
Little River, SC 29566-1523

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

State licenses

LicenseStateTypeSpecialty
2291SCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Consortium Inc. 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": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306972800000",
    "number": "1467746933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1523",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295661523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 CAROLINA EXCHANGE DR",
            "address_2": "SUITE 102",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794394",
            "telephone_number": "843-455-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSTON",
        "first_name": "DIANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-02",
        "last_updated": "2011-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "2291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2011; 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.