Individual provider Active NPI

Angela Campanelli

  • Speech-Language Pathologist
  • Dayton, OH
National Provider Identifier
1063955516
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3918 Issued in OH
Practice address
1222 S Patterson Blvd
Dayton, OH 45402-2684
Phone
(937) 496-2600
Fax
(937) 496-2614
NPI assigned
Nov 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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 3918 OH Primary

Addresses

Primary practice location

1222 S Patterson Blvd
Dayton, OH 45402-2684

Mailing address

1240 Lincoln Park Blvd
Kettering, OH 45429-3612
Phone (937) 479-4279

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180329000694 OH Practitioner - Qualified Speech Language Pathologist 9335401462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Ohio ENT Specialists IncGroup PAC ID 2163403098, 42 clinicians

Practice addresses (Care Compare)

1222 S Patterson Blvd
Suite 400
Dayton, OH 45402-2642
Phone 9374962620437

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3918OHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Ohio ENT Specialists Inc CurrentSince Jan 1, 2018 Accepting new patients

Locations

1222 S Patterson Blvd
Dayton, OH 45402
Phone (937) 229-9706

1222 S Patterson Blvd
Ste 400
Dayton, OH 45402
Phone (937) 496-2600

5971 Golf Club Ln
Fairfield Township, OH 45011
Phone (513) 785-4304

1930 Prime Ct
Ste 104
Troy, OH 45373
Phone (937) 832-3582

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HDIFCD

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1480464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1063955516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 LINCOLN PARK BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454293612",
            "telephone_number": "937-479-4279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 S PATTERSON BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454022684",
            "telephone_number": "937-496-2600",
            "fax_number": "937-496-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPANELLI",
        "first_name": "ANGELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-30",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "3918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.