Individual provider Active NPI

Melissa Amerson Goolsby, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Navarre, FL
National Provider Identifier
1831426121
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 7887 Issued in FL
Practice address
7552 Navarre Pkwy
Suite 32
Navarre, FL 32566-7305
Phone
(850) 698-9755
NPI assigned
Nov 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-13-14378
Developmental Therapist 222Q00000X
Speech-Language Pathologist 235Z00000X SA 7887 FL Primary

Addresses

Primary practice location

7552 Navarre Pkwy
Suite 32
Navarre, FL 32566-7305

Mailing address

7552 Navarre Pkwy
Suite 32
Navarre, FL 32566-7305
Phone (850) 698-9755

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101227000630 FL Practitioner - Qualified Speech Language Pathologist 1052446176 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SA 7887FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Across the Board Therapy Group, LLC Speech-Language Pathologist CurrentSince Jan 11, 2010 Accepting new patients
Navarre Medical Associates Past Accepting new patients
Therapease LLC Developmental Therapist PastSince May 21, 2010 Accepting new patients

Locations

7552 Navarre Pkwy
Unit 32
Navarre, FL 32566
Phone (850) 939-3944

8740 Ortega Park Dr
Navarre, FL 32566
Phone (850) 384-6111

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1257638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1831426121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7552 NAVARRE PKWY",
            "address_2": "SUITE 32",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325667305",
            "telephone_number": "850-698-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7552 NAVARRE PKWY",
            "address_2": "SUITE 32",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325667305",
            "telephone_number": "850-698-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOLSBY",
        "first_name": "MELISSA",
        "middle_name": "AMERSON",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-08",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-13-14378",
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 7887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Navarre, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; 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.

Verify at the official NPI Registry.