Organization Active NPI

Mansfield Pediatric Therapy

  • Speech-Language Pathologist
  • Mansfield, OH
National Provider Identifier
1073342549
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
MANSFIELD PEDIATRIC THERAPY
Practice address
1 Marion Ave Ste 107
Mansfield, OH 44903-7906
Phone
(419) 571-5873
NPI assigned
Jul 31, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Authorized official

Name
Amanda Kulka, SLPNPI 1033966221
Title
Speech-Language Pathologist
Phone
(419) 571-5873

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

1 Marion Ave Ste 107
Mansfield, OH 44903-7906

Mailing address

1 Marion Ave Ste 107
Mansfield, OH 44903-7906
Phone (419) 571-5873

National Provider Directory

National Provider Directory

Locations

1 Marion Ave
Ste 107
Mansfield, OH 44903
Phone (419) 571-5873

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1073342549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MARION AVE STE 107",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449037906",
            "telephone_number": "419-571-5873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MARION AVE STE 107",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449037906",
            "telephone_number": "419-571-5873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANSFIELD PEDIATRIC THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "KULKA",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "419-571-5873",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.