Dayna Vivacqua Revetti, MA CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP10018 Issued in OH

Practice address

135 Heron Bay Dr
Poland, OH 44514-3200

Phone

(330) 720-0915

NPI assigned

Nov 23, 2011

Last updated

May 23, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Delaware Speech and Hearing Center

  • Audiologist
  • Delaware, OH
  • NPI 1598808206

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1053688762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 HERON BAY DR",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143200",
            "telephone_number": "330-720-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 HERON BAY DR",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143200",
            "telephone_number": "330-720-0915"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "494 W Central Ave",
            "address_2": "Suite 1",
            "address_purpose": "LOCATION",
            "city": "Delaware",
            "state": "OH",
            "postal_code": "430151470",
            "country_code": "US",
            "telephone_number": "740-369-3650",
            "fax_number": "740-369-0812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REVETTI",
        "first_name": "DAYNA",
        "middle_name": "VIVACQUA",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-23",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP10018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2095254",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• RC Compounding Services LLC
• Sahadev Thugu Reddy, MD
• Tami Regule, RPH
• Denise Reidy, PHARMD.
• Addison Remick
• Susan Ripple
• Steven Doyce Robbins, MD
• Amanda L. Roeder, APRN
• William Joseph Rogers, CNP
• Daniel Romeo

• Speech-Language Pathologist in Poland, OH
• Providers in Poland, OH by specialty
• Speech-Language Pathologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.