Active NPI
Melinda Olson, MED, CCC SLP
- Speech-Language Pathologist
- Tyler, TX
National Provider Identifier
1487878880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 100050
- Practice address
- 1002 E Dulse St
Tyler, TX 75701-7144 - Phone
- (903) 595-3524
- NPI assigned
- Apr 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 100050 | TX | Primary |
Addresses
Primary practice location
1002 E Dulse St
Tyler, TX 75701-7144
Mailing address
1002 E Dulse St
Tyler, TX 75701-7144
Phone (903) 595-3524
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 87895T | Other | TX | BLUE CROSS BLUE SHIELD |
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 Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100050 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487878880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1002 E DULSE ST",
"city": "TYLER",
"state": "TX",
"postal_code": "757017144",
"telephone_number": "903-595-3524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1002 E DULSE ST",
"city": "TYLER",
"state": "TX",
"postal_code": "757017144",
"telephone_number": "903-595-3524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "MELINDA",
"name_prefix": "Mrs.",
"credential": "MED, CCC SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "100050",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "87895T",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
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.