Alisha Gholston Comer, MS,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

S2951 Issued in MS

Practice address

5600 Goodman Rd Ste D
Olive Branch, MS 38654-7002

Phone

(662) 895-4545

Fax

(662) 895-4546

NPI assigned

Jul 23, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Alisha Ann Gholston Former name

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pro PTGroup PAC ID 6901060110, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pro PT

  dba Pro Therapy

  • Physical Therapist
  • Mantachie, MS
  • NPI 1629343124
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700807690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 GOODMAN RD STE D",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386547002",
            "telephone_number": "662-895-4545",
            "fax_number": "662-895-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 GOODMAN RD STE D",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386547002",
            "telephone_number": "662-895-4545",
            "fax_number": "662-895-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMER",
        "first_name": "ALISHA",
        "middle_name": "GHOLSTON",
        "name_prefix": "Mrs.",
        "credential": "MS,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S2951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09558719",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALISHA",
            "last_name": "GHOLSTON",
            "middle_name": "ANN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• City of Olive Branch (Olive Branch Fire Dept. Ambulance)
• Heather Nicole Clayton, LPC
• Latoya Cole, NCC
• Karissa Diane Coleman, LPC
• Greene Berry Colvin IV, MD
• Comprehensive Stafffing Services
• Confident Living LLC
• Julia Conner-Mendez, NP
• Kylee Alexis Cook, APRN, FNP-C
• Kelcey Raye Cooper, PA-C, ATC

• Speech-Language Pathologist in Olive Branch, MS
• Providers in Olive Branch, MS by specialty
• Speech-Language Pathologist in Mississippi

• 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.
• 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.