Active NPI
Crystal Nichole Thomason, M.ED. CCC-SLP
- Speech-Language Pathologist
- Lake Jackson, TX
National Provider Identifier
1790990885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 103124
- Practice address
- 105 Any Way St
Lake Jackson, TX 77566-4198 - Phone
- (229) 460-1555
- NPI assigned
- May 11, 2007
- Last updated
- Jul 8, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 103124 | TX | Primary |
| Speech-Language Pathologist | 235Z00000X | SLP006390 | GA |
Addresses
Primary practice location
105 Any Way St
Lake Jackson, TX 77566-4198
Mailing address
11 Cedar Ridge Road
Tifton, GA 31794
Phone (229) 460-1555
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP006390 | GA | MD | Speech-Language Pathologist |
| 103124 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Golden Speech Therapy, Inc | Current | Accepting new patients |
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.
-
- Hearing and Speech Clinic/Center
- Tifton, GA
- NPI 1073041919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790990885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 CEDAR RIDGE ROAD",
"city": "TIFTON",
"state": "GA",
"postal_code": "31794",
"telephone_number": "229-460-1555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 ANY WAY ST",
"city": "LAKE JACKSON",
"state": "TX",
"postal_code": "775664198",
"telephone_number": "229-460-1555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMASON",
"first_name": "CRYSTAL",
"middle_name": "NICHOLE",
"name_prefix": "Ms.",
"credential": "M.ED. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "103124",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP006390",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lake Jackson, TX
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.