Healthcare Provider Details

I. General information

NPI: 1386437549
Provider Name (Legal Business Name): MEGAN NEWBERRY MS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15707 PINEHURST DR
BASEHOR KS
66007-8228
US

IV. Provider business mailing address

1206 RIDGE CIR APT C
TONGANOXIE KS
66086-9302
US

V. Phone/Fax

Practice location:
  • Phone: 913-624-6703
  • Fax:
Mailing address:
  • Phone: 816-835-5669
  • Fax: 816-835-5669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number5949
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: