Active NPI
Elizabeth Olguin, MED CCC-SLP
- Speech-Language Pathologist
- Douglas, GA
National Provider Identifier
1790419927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP011957
- Practice address
- 515 Peterson Ave S Ste B
Douglas, GA 31533-5244 - Phone
- (912) 501-4047
- Fax
- (912) 501-5289
- NPI assigned
- Jul 13, 2022
- Last updated
- Jul 13, 2022
- Sex
- Female
- Sole proprietor
- No
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 | SLP011957 | GA | Primary |
Addresses
Primary practice location
515 Peterson Ave S Ste B
Douglas, GA 31533-5244
Mailing address
515 Peterson Ave S Ste B
Douglas, GA 31533-5244
Phone (912) 501-4047
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220725000909 | GA | Practitioner - Qualified Speech Language Pathologist | 5991186884 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP011957 | GA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657670400000",
"number": "1790419927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 PETERSON AVE S STE B",
"city": "DOUGLAS",
"state": "GA",
"postal_code": "315335244",
"telephone_number": "912-501-4047",
"fax_number": "912-501-5289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 PETERSON AVE S STE B",
"city": "DOUGLAS",
"state": "GA",
"postal_code": "315335244",
"telephone_number": "912-501-4047",
"fax_number": "912-501-5289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLGUIN",
"first_name": "ELIZABETH",
"credential": "MED CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-13",
"last_updated": "2022-07-13",
"certification_date": "2022-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP011957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglas, GA
- James Stephen Nobles, P.A.
- Katherine Joann Norris
- Walker Reid Nugent
- Mallory Lynn O'Brien, FNP-C
- Stuart Jackson O'Steen, CRNA
- Open MRI of Douglas LLC
- Open MRI of Douglas LLC
- Orthopedic Surgeons of Georgia LLC (Orthopedic Surgeons of Georgia)
- Orthopedic Surgeons of Georgia, LLC (Orthopedic Surgeons of Georgia)
- Orthopedic Surgeons of Georgia, LLC (Optim Pain Management-Douglas)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.