Active NPI
Encie Jonas Super, C.C.C.
- Speech-Language Pathologist
- Shaker Heights, OH
National Provider Identifier
1013146125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP-2797
- Practice address
- 16220 Aldersyde Dr
Shaker Heights, OH 44120-2510 - Phone
- (216) 283-4141
- NPI assigned
- Jul 9, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | SP-2797 | OH | Primary |
Addresses
Primary practice location
16220 Aldersyde Dr
Shaker Heights, OH 44120-2510
Mailing address
16220 Aldersyde Dr
Shaker Heights, OH 44120-2510
Phone (216) 283-4141
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 |
|---|---|---|---|
| SP-2797 | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247097600000",
"number": "1013146125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16220 ALDERSYDE DR",
"city": "SHAKER HEIGHTS",
"state": "OH",
"postal_code": "441202510",
"telephone_number": "216-283-4141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16220 ALDERSYDE DR",
"city": "SHAKER HEIGHTS",
"state": "OH",
"postal_code": "441202510",
"telephone_number": "216-283-4141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUPER",
"first_name": "ENCIE",
"middle_name": "JONAS",
"name_prefix": "Mrs.",
"credential": "C.C.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-09",
"last_updated": "2009-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "SP-2797",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shaker Heights, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.