Active NPI
Dree Ellingworth, CCC-SLP
- Speech-Language Pathologist
- Fishers, IN
National Provider Identifier
1003346677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22007852A
- Practice address
- 10294 E 96TH St
Fishers, IN 46037-9497 - Phone
- (515) 460-0537
- NPI assigned
- Jun 15, 2017
- 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 | 22007852A | IN | Primary |
Addresses
Primary practice location
10294 E 96TH St
Fishers, IN 46037-9497
Mailing address
14198 Bay Willow Dr
Fishers, IN 46037-0029
Other practice location 1
1555 SE Delaware Ave Ste O
Ankeny, IA 50021-4011
Phone (515) 261-2402
Other practice location 2
1500 Pride Ave
Madisonville, KY 42431-9157
Phone (270) 821-1813
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22007852A | IN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KP Enterprises Iowa | Past | Accepting new patients | |
| KP Enterprises Iowa | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Ankeny, IA
- NPI 1518478684
Speech-Language Pathologist
-
- Behavior Analyst
- Ankeny, IA
- NPI 1659881035
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651190400000",
"number": "1003346677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14198 BAY WILLOW DR",
"city": "FISHERS",
"state": "IN",
"postal_code": "460370029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10294 E 96TH ST",
"city": "FISHERS",
"state": "IN",
"postal_code": "460379497",
"telephone_number": "515-460-0537"
}
],
"practiceLocations": [
{
"address_1": "1555 SE Delaware Ave Ste O",
"address_purpose": "LOCATION",
"city": "Ankeny",
"state": "IA",
"postal_code": "500214011",
"country_code": "US",
"telephone_number": "515-261-2402",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1500 Pride Ave",
"address_purpose": "LOCATION",
"city": "Madisonville",
"state": "KY",
"postal_code": "424319157",
"country_code": "US",
"telephone_number": "270-821-1813",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ELLINGWORTH",
"first_name": "DREE",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-15",
"last_updated": "2022-04-29",
"certification_date": "2022-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22007852A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fishers, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.