Angela Lyn Northcutt, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

104403 Issued in TX

Practice address

2425 E Southlake Blvd
#100
Southlake, TX 76092-6674

Phone

(817) 442-0222

Fax

(817) 442-0223

NPI assigned

Oct 10, 2012

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 names 1

• Angela Lyn Montez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Pediaplex Management Company LLC

  • Speech-Language Pathologist
  • Southlake, TX
  • NPI 1821374687
  NPD (past)

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

{
    "created_epoch": "1349827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349827200000",
    "number": "1790037018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 E SOUTHLAKE BLVD",
            "address_2": "#100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926674",
            "telephone_number": "817-442-0222",
            "fax_number": "817-442-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 E SOUTHLAKE BLVD",
            "address_2": "#100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926674",
            "telephone_number": "817-442-0222",
            "fax_number": "817-442-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHCUTT",
        "first_name": "ANGELA",
        "middle_name": "LYN",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-10",
        "last_updated": "2012-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "104403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "MONTEZ",
            "middle_name": "LYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• North Texas Brain and Wellness, Inc.
• North Texas Lung & Sleep Clinic, PA
• North Texas Pain Institute
• North Texas Plastic Surgery
• North Tower Care Group, LP (The Landing at Watermere)
• Lisa Lynn Northcutt, RN, CRNFA
• Marilyn Nottorf, O.T.R.
• Matthew Novak, M.D.
• Ryan Matthew Novak, RBT
• Janet Nowell, RBT

• Speech-Language Pathologist in Southlake, TX
• Providers in Southlake, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; 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.