Individual provider Active NPI

Alycia Gabrielle Sansbury

  • Speech-Language Pathologist
  • West Columbia, SC
National Provider Identifier
1730963240
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
437A Ravenscroft Rd
West Columbia, SC 29172-3157
Phone
(843) 269-6790
NPI assigned
Aug 24, 2023
Last updated
Aug 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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 NU Primary

Addresses

Primary practice location

437A Ravenscroft Rd
West Columbia, SC 29172-3157

Mailing address

437A Ravenscroft Rd
West Columbia, SC 29172-3157
Phone (843) 269-6790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231009003458 SC Practitioner - Qualified Speech Language Pathologist 7315392479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Weston Group of South Carolina IncGroup PAC ID 2062651185, 80 clinicians

Practice addresses (Care Compare)

5422 Augusta Rd
Lexington, SC 29072-3892
Phone (803) 520-5850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9161SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
The Weston Group of South Carolina Inc Speech-Language Pathologist CurrentSince Sep 8, 2023 Accepting new patients

Locations

209 Broad St
Camden, SC 29020
Phone (803) 272-4445

872 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 347-3050

5422 Augusta Rd
Lexington, SC 29072
Phone (803) 520-5850

3736 Robert M Grissom Pkwy
Myrtle Beach, SC 29577
Phone (843) 448-9300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1730963240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437A RAVENSCROFT RD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291723157",
            "telephone_number": "843-269-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437A RAVENSCROFT RD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291723157",
            "telephone_number": "843-269-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANSBURY",
        "first_name": "ALYCIA",
        "middle_name": "GABRIELLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.