Individual provider Active NPI

Emily Lyn Van Dyke

  • Speech-Language Pathologist
  • Frisco, TX
National Provider Identifier
1649912080
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
118213 Issued in TX
Practice address
11330 Legacy Dr Ste 306
Frisco, TX 75033-1217
Phone
(469) 297-6340
NPI assigned
Apr 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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 118213 TX Primary

Addresses

Primary practice location

11330 Legacy Dr Ste 306
Frisco, TX 75033-1217

Mailing address

11330 Legacy Dr Ste 306
Frisco, TX 75033-1217
Phone (469) 297-6340

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
118213TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Frisco Feeding & Speech Therapy Speech-Language Pathologist CurrentSince Mar 5, 2023 Accepting new patients

Locations

11330 Legacy Dr
Ste 306
Frisco, TX 75033
Phone (469) 297-6340

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": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1649912080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11330 LEGACY DR STE 306",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750331217",
            "telephone_number": "469-297-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11330 LEGACY DR STE 306",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750331217",
            "telephone_number": "469-297-6340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DYKE",
        "first_name": "EMILY",
        "middle_name": "LYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-07",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "118213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; 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.