Individual provider Active NPI

Cathy J Puch, MA CCC SLP

  • Speech-Language Pathologist
  • Dyer, IN
National Provider Identifier
1053379396
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22002747A Issued in IN
Practice address
1501 Joliet Street
Unit B2
Dyer, IN 46311
Phone
(219) 322-1415
Fax
(219) 322-1414
NPI assigned
May 3, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 22002747A IN Primary

Addresses

Primary practice location

1501 Joliet Street
Unit B2
Dyer, IN 46311

Mailing address

1501 Joliet Street
Unit B2
Dyer, IN 46311
Phone (219) 322-1415

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
22002747AINMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1053379396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 JOLIET STREET",
            "address_2": "UNIT B2",
            "city": "DYER",
            "state": "IN",
            "postal_code": "46311",
            "telephone_number": "219-322-1415",
            "fax_number": "219-322-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 JOLIET STREET",
            "address_2": "UNIT B2",
            "city": "DYER",
            "state": "IN",
            "postal_code": "46311",
            "telephone_number": "219-322-1415",
            "fax_number": "219-322-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCH",
        "first_name": "CATHY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "MA CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22002747A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyer, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.