NPIMap

Organization Active NPI

Cleveland Hearing and Speech Center

  • Speech-Language Pathologist
  • Cleveland, OH
National Provider Identifier
1043397458
Registry record updated Jun 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP-5730 Issued in OH
Legal business name
CLEVELAND HEARING AND SPEECH CENTER
Practice address
11635 Euclid Ave
Cleveland, OH 44106-4319
Phone
(216) 231-8787
Fax
(216) 231-7141
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2020

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

Authorized official

Name
Dr. Jennell C. Vick, PHD
Title
Executive Director
Phone
(216) 231-8787

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X A-00915 OH
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X SP-5730 OH Primary

Addresses

Primary practice location

11635 Euclid Ave
Cleveland, OH 44106-4319

Mailing address

11635 Euclid Ave
Cleveland, OH 44106-4319
Phone (216) 231-8787

Other identifiers 1

IdentifierTypeStateIssuer
0325500MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081003000000 OH Part B Supplier - Clinic/Group Practice 2163590217 Receives reassigned benefits from 26 practitioners
Practice locations: Broadview HTS, OH; Cleveland, OH; Lyndhurst, OH; Westlake, OH

National Provider Directory

National Provider Directory

Locations

11206 Euclid Ave
Cleveland, OH 44106
Phone (216) 231-8787

11635 Euclid Ave
Cleveland, OH 44106
Phone (216) 231-8787

6001 Euclid Ave
Ste 10
Cleveland, OH 44103

6001 Euclid Ave
Ste 100
Cleveland, OH 44103
Phone (216) 231-8787

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591315200000",
    "number": "1043397458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11635 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441064319",
            "telephone_number": "216-231-8787",
            "fax_number": "216-231-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11635 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441064319",
            "telephone_number": "216-231-8787",
            "fax_number": "216-231-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND HEARING AND SPEECH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A",
        "authorized_official_last_name": "VICK",
        "authorized_official_first_name": "JENNELL",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "216-231-8787",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A-00915",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP-5730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0325500",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.